124例肺癌脑转移的临床分析

目的　探讨肺癌脑转移的治疗效果和有关预后因素与生存的关系。方法　对 1992年 1月至 2 0 0 2年 1月住院的 12 4例肺癌脑转移患者的临床资料进行回顾性分析。结果　全组近期的缓解率为 89.2 %,1年生存率为 2 1.8%,中位生存时间为 6个月 ,其中手术加放疗组中位生存期 7.1个月和 1年生存率为 40 .0 %,放化疗组为 7.0个月和 2 7.4%,都显著优于单放组 4.8个月和 11.5 %(P<0 .0 5 ) ,分析显示生存率与原发灶未控 ,合并颅外转移 ,放疗剂量 ,身体状况有关 ,与肺原发灶病理类型 ,脑转移灶数目无关。结论　影响肺癌转移预后的主要因素是脑转移时原发灶控制与否 ,是否合并颅外转移 ,脑部放疗剂量 ,身体状况。对于肺癌脑转移的病人确诊后 ,只要身体可以耐受应进行放疗为主的综合治疗 ,可以改善临床症状和延长生存时间。

Clinical Analysis of 124 Cases of Lung Cancer with Brain Metastasis

Objective The effects of therapy of the 124 patients with lung cancer metastasis of the brain and the relations between the related prognostic factor and survival were analyzed.Methods The clinical date of 124 patients with brain metastasis from lung cancer from January 1992 to January 2002 were analyzed retrospectively.Results The one year survival rate of the whole group were 21.8%. Median survival time is 6 months. The median survival period and one- year survival rate were 7.1 months and 40.0% in surgery plus radiotherapy and 7.0 months and 27.4% in chemotherapy plus radiotherapy group and 4.8 months and 11.5% in radiotherapy alone group. There was significant correlation between the survivals and uncontrolled primary tumor or multiple extracranial lesions in addition to brain metastasis or irradiation dose.Conclusions For patients with brain metastasis from lung carcinoma, the presence of uncontrolled primary tumor at the time of developing brain metastasis, multiple extracranial lesions in addition to brain metastasis and the irradiation dose were factors that could be used to distinguish patients with an unfavorable outcome. Comprehensive treatment with the major of radiotherapy should be curried out as soon as possible when the lung cancer with metastasis of the brain is diagnosed, This treatment may improve the clinical symptom and longthen the survival time.