56例非小细胞肺癌脑转移外科手术治疗预后的影响因素

Influence factors on prognosis of surgical treatment of non small cell lung cancer with brain metastasis

目的分析非小细胞肺癌脑转移外科手术治疗预后的影响因素。方法选取2011-01—2016-12邯郸市第一医院收治的56例接受外科手术治疗的非小细胞肺癌脑转移患者,回顾性分析其临床资料。结果单因素分析显示,性别(t=7.057,P=0.000)、脑转移是否第一次产生(t=2.217,P=0.031)、术后是否放疗(t=3.044,P=0.004)、术后是否化疗(t=3.463,P=0.001)、肿瘤数目(t=4.650,P=0.000)可以对术后生存期产生影响;多因素分析显示,对非小细胞肺癌脑转移患者手术治疗的预后产生影响的独立因素为颅内是否首发(P=0.027)、术后是否放疗(P=0.000)、术后是否化疗(P=0.000)、肿瘤数(P=0.000);单纯手术组生存时间为(11.28±3.26)个月,其中术后6个月、12个月生存率分别为66.67%、50.00%;术后放化疗组生存时间(14.73±4.05)个月,术后6个月、12个月生存率分别为90.91%、84.85%,单纯手术组生存时间明显小于术后放化疗组(P<0.05)。结论对肺癌脑转移患者行外科手术治疗,对术后预后产生影响的因素主要为颅内是否首发、术后是否放疗、术后是否联合特罗凯靶向化疗以及肿瘤数,其中,术后实施放疗联合特罗凯靶向化疗能够显著延长患者生存时间,提高1a内生存率。

Objective To investigate the influence factors on prognosis of surgical treatment of non small cell lung cancer with brain metastasis.Methods 56 cases with non small cell lung cancer with brain metastasis surgical treatment in our hospital from January 2011 to December 2016 were selected and their complete clinic data were retrospectively analyzed.Results Single factor analysis showed gender(t=7.057,P=0.000),first occurrence of brain metastases or not(t=2.217,P=0.031),whether or not had postoperative radiotherapy(t=3.044,P=0.004),whether or not had postoperative chemotherapy(t=3.463,P=0.001),the number of tumor(t=4.650,P=0.000)may had influence on postoperative survive period.Multiple factor analysis showed that independent factors of patients with non small cell lung cancer with brain metastasis were whether or not the first occurrence of brain metastases(P=0.027),whether or not had postoperative radiotherapy(P=0.000),whether or not had postoperative chemotherapy(P=0.000),the number of tumor(P=0.000);survival time of simple operation group was(11.28±3.26)months,survival rate after 6,12 months were 66.67%,50.00%,obviously less than the survival time of the chemoradiotherapy group(14.73±4.05)months,survival rate of the chemoradiotherapy group after 6,12 months were 90.91%,84.85%,the survival time of the surgery group was significantly less than that of the postoperative radiotherapy and chemotherapy group(P<0.05).Conclusion Surgical treatment of patients with lung cancer with brain metastases,the main factors affecting postoperative prognosis are whether or not the first intracranial,whether or notinitial radiotherapy,whether or not postoperative chemotherapy combined with Tarceva target and tumor number,including radiotherapy combined with Tarceva targeted chemotherapy can significantly prolong the survival of patients and improve survival within 1 year.