非小细胞肺癌脑转移瘤放疗的疗效及预后影响因素分析

目的探讨非小细胞肺癌脑转移瘤放疗的疗效及预后影响因素,总结其临床应用价值。方法选择2007年1月至2009年1月入我院治疗的58例非小细胞肺癌脑转移瘤患者为研究对象进行回顾性分析,通过KPS评分、治疗有效率、6个月、1年、2年的生存率评价疗效,采用单因素分析及COX风险比例模型多因素分析探讨影响其预后的因素。结果患者的中位生存期为8个月,治疗总有效率为84.5%,6个月、1年、2年的生存率分别为78%、30%、10.3%,无放疗相关性死亡发生。单因素分析显示,KPS评分、治疗方式、转移瘤数目、原发性肿瘤控制及患者年龄是影响患者生存的预后因素;多因素分析显示,原发肿瘤是否控制及转移瘤数目是影响患者生存的独立预后因素。结论非小细胞肺癌脑转移瘤放疗的疗效较好,放疗后患者的预后受到多种因素所控制,原发肿瘤是否控制及转移瘤数目起关键的作用,具有重要的临床意义。

Analysis of Therapeutic Effects and Prognostic Predictors of Non-small Cell Lung Cancer with Brain Metastases Treated by Radiotherapy

Objective To evaluate the therapeutic effects and prognosis predictors of brain metastases from Non-small cell lung cancer(NSCLC) treated by radiotherapy and summarize its clinical value.Methods 58 patients with NSCLC who were admitted in our hospital from January 2007 to January 2009 were selected and reviewed retrospectively.KPS scores,effective rate as well as 6-month,1-year and 2-year survival rate were calculated to evaluate the therapeutic effect of radiotherapy.Univariate analysis and multivariate analysis by COX’s proportional hazard model were used to analyze the prognosis predictors.Results The median survival time was 8 months for all the patients,and the total effective rate was 84.5%.The 6-month,1-year and 2-year survival rate was respectively 78%,30% and 10.3%,and no radiotherapy related death was observed.The univariate analysis indicated that the KPS scores,treatment model,number of brain metastases,control of primary tumor and age of patients were prognostic predictors of survival for patients;while multivariate analysis showed whether the primary tumor was better controlled and the number of brain metastases were independent prognostic predictors of survival for patients.Conclusion Radiotherapy was effective to NSCLC patients with brain metastases.The prognosis of patients after radiotherapy was affected by several factors,the primary tumor better controlled or not and the number of brain metastases were of great importance and clinical significance.