小细胞肺癌脑转移发生时间与预后分析

目的 探讨小细胞肺癌(SCLC)脑转移发生时间与预后的关系。 方法 回顾分析2007-2015年收治的首发远处转移部位为脑的局限期SCLC患者 131例,依据中位无脑转移生存期(BMFS)将病例分为A、B两组,其中BMFS≤10个月为A组(61例),BMFS>10个月为B组(70例)。Kaplan-Meier法计算生存率,Logrank法比较组间差异,Cox模型多因素预后分析。 结果 131例SCLC患者中位总生存期及1、2、3年生存率分别为22.5个月及87.3%、44.7%、20.8%;全组中位脑转移后生存期及1、2年生存率分别为9.3个月及39.3%、14.8%。由于A、B组脑转移后中位生存期相近(分别为8.6、9.3个月,P=0.695),进而对未行预防性脑照射的A、B两组患者进行分析,其脑转移后生存期也相近(P=0.240~0.731)。 结论 SCLC脑转移发生时间与总生存相关,而与脑转移后生存无关,因此着重预防和减少脑转移的发生可能是提高SCLC患者生存的重要手段。

Association between the timing of brain metastases and the prognosis of small cell lung cancer

Objective To investigate the association between the timing of brain metastases and the prognosis of patients with small cell lung cancer (SCLC). Methids A retrospective analysis was performed in 131 patients with limited-stage SCLC firstly metastasized to the brain were admitted to our hospital from 2007 to 2015.According to the median bone metastasis-free survival (BMFS),all patients were divided into A group (BMFS≤10 months,n=61) and B group (BMFS>10 months,n=70).The survival rates were analyzed using the Kaplan-Meier method. Between-group comparison was performed by log-rank test. The Cox regression model was used for multivariate prognostic analysis. Results In all 131 patients,the median overall survival (OS) and 1-,2-,and 3-year OS rates were 22.5 months,87.3%,44.7%,and 20.8%,respectively. The median OS after brain metastases and 1-and 2-year OS rates were 9.3 months,39.3% and 14.8%,respectively. No statistical significance was observed in the median OS after brain metastases between the A and B groups (8.6 vs. 9.3 months,P=0.695).Moreover,the OS after brain metastases did not significantly differ in patients without PCI or those receiving different therapies after brain metastases between two groups (P=0.240-0.731). Conclusions The timing of SCLC with brain metastases is significantly correlated with the OS rather than the OS after brain metastases. Therefore,prevention of brain metastases may be an effective approach to prolong the OS of patients with SCLC.