EGFR不同突变亚型与肺腺癌脑转移预后的相关性分析

目的 探讨肺腺癌脑转移患者EGFR不同突变亚型与预后的相关性。方法 回顾分析2010—2015年本院收治的经EGFR基因突变检测的肺腺癌脑转移患者256例临床资料,筛选脑转移的预后影响因素。Kaplan-Meier法计算生存率Logrank法检验和单因素预后分析,Cox模型多因素预后分析。结果 全组患者中位生存期为10.13个月。单因素分析显示性别、EGFR突变状态、19外显子缺失突变、脑转移时KPS评分、靶向治疗与预后有关(P=0.006、0.001、0.010、0.000、0.003),多因素分析显示脑转移时KPS评分、19外显子缺失突变为脑转移患者预后影响因素(P=0.000、0.045)。将全组病例纳入RPA预后分级指数,检验显示差异有统计学意义(P=0.000)。结论 19外显子缺失突变是肺腺癌脑转移患者的预后影响因素,可以考虑将其纳入肺腺癌脑转移瘤预后评分系统。EGFR-TKI使EGFR基因突变肺腺癌脑转移患者生存获益,尤其是19外显子缺失突变患者。     

厄洛替尼同步WBRT对EGFR突变阳性肺腺癌多发脑转移的临床疗效

目的 探讨厄洛替尼同步WBRT治疗肺腺癌多发脑转移的临床疗效和安全性,为改善患者预后提供客观依据。方法 选取我院肿瘤科收治的EGFR基因突变阳性肺腺癌脑转移患者89例,根据患者采用不同的脑转移治疗方法分为研究组45例和对照组44例,研究组给予厄洛替尼同步WBRT,对照组首先给予单纯口服厄洛替尼28 d后同时WBRT。采用Kaplan-Meier法计算生存率并Logrank法检验,余用χ²检验。结果 研究组脑转移灶的客观缓解率(78%)明显高于对照组(55%)(P=0.000)。研究组和对照组的中位PFS分别为9.1个月(95%CI为5.18~12.47)和5.6个月(95%CI为3.46~9.12)(P=0.078)。研究组和对照组的中位OS分别为14.3个月(95%CI为9.51~17.82)和9.7个月(95%CI为4.59~16.74)(P=0.032)。研究组患者头痛、头昏发生率明显高于对照组患者(38%∶14%,P=0.029;33%∶9%,P=0.020)。结论 厄洛替尼同步WBRT治疗EGFR突变阳性肺腺癌多发脑转移较单纯采用厄洛替尼具有更高的有效率,并延长了患者神经系统PFS和OS期。     

全脑放疗时间对EGFR突变非小细胞肺癌脑转移患者生存的影响

背景与目的全脑放疗（whole brain radiotherapy, WBRT）在表皮生长因子受体（epidermal growth factor receptor,EGFR）突变的非小细胞肺癌（non-small cell lung cancer, NSCLC）脑转移患者治疗中何时应用尚无高级别的循证医学证据。本研究旨在探讨WBRT的参与时间对携有EGFR突变的NSCLC脑转移患者生存的影响。方法2009年8月-2015年5月在我院确诊的EGFR突变伴脑转移的晚期NSCLC共78例患者,均接受WBRT及EGFR酪氨酸激酶抑制剂（EGFR tyrosine kinase inhibitors, EGFR-TKIs）治疗的48例初治患者进入临床分析,采用Cox比例风险模型分析患者颅内无进展生存期（progression-free survival, PFS）及总生存期（overall survival, OS）的影响因素。结果全组患者颅内客观缓解率（objective response rate, ORR）为81.3%,颅内疾病控制率（disease control rate, DCR）为93.8%,中位颅内PFS为10个月,中位OS为18个月。颅内PFS的多因素分析显示,美国东部肿瘤协作组评分（Eastern Cooperative Oncology Group performance status, ECOG PS）0分-1分（HR=30.436,95%CI：4.721-196.211,P<0.001）及早期WBRT患者（HR=3.663,95%CI：1.657-8.098,P=0.001）的颅内PFS更佳。OS的多因素分析显示,ECOG PS 0分-1分（HR=57.607,95%CI：6.135-540.953,P<0.001）、早期WBRT（HR=2.757,95%CI：1.140-6.669,P=0.024）及立体定向放射外科（stereotaxic radio surgery, SRS）的应用（HR=5.964,95%CI：1.895-18.767,P=0.002）是患者OS的独立预后因素。结论早期WBRT联合TKIs治疗可改善EGFR突变的NSCLC脑转移患者的预后,尚有待大样本的前瞻性临床试验验证。     

肺癌脑转移患者容积旋转调强放疗剂量学及预后分析

目的脑转移瘤是颅内最常见的恶性肿瘤,其中肺癌转移风险最高,本研究分析应用容积旋转调强(volumetric modulated arc therapy,VMAT)技术行全脑+病灶同步推量放疗肺癌脑转移瘤的剂量学优势及预后。方法回顾性分析2016-01-01-2018-04-30郑州大学附属肿瘤医院接受VMAT放疗的40例肺癌脑转移患者临床资料。全脑放疗(whole brain radiotherapy,WBRT)剂量为30~40Gy,肿瘤靶区(gross tumor volume,GTV)同步推量至35~60Gy,分10~20次。随机选取10例患者,做调强适形放疗(intensity modulated radiation therapy,IMRT)9野同步推量计划,评估其适形指数(conformity index,CI)、均匀指数(homogeneity index,HI)。采用Kaplan-Meier法计算颅内无进展生存期(intracranial progression-free survival,IPFS)和总生存期(overall survival,OS),并采用Log-rank检验行单因素分析和Cox回归模型多因素分析。结果VMAT在脑转移瘤靶区的CI(t=4.255,P=0.002)、HI(t=-2.404,P=0.040)及全脑靶区中CI(t=7.384,P<0.001)均优于IMRT,且随着脑转移瘤个数的增加,VMAT计划的优势更加明显。1年IPFS为52.3%,1和2年OS分别为56.8%和36.7%。单因素分析显示,靶向治疗(χ^2=4.084,P=0.043)、KPS(χ^2=10.072,P=0.0002)、RPA分级(χ^2=10.102,P=0.006)与IPFS有关联,靶向治疗(χ^2=4.246,P=0.039)、KPS(χ^2=5.329,P=0.021)、RPA分级(χ^2=6.608,P=0.037)、GPA评分(χ^2=4.001,P=0.045)、中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)(χ^2=4.081,P=0.043)与OS有关联。多因素分析显示,靶向治疗(HR=0.218,95%CI:0.054~0.873,P=0.031)是IPFS的独立影响因素,KPS(HR=2.317,95%CI:0.171~31.376,P=0.047)和靶向治疗(HR=0.309,95%CI:0.113~0.851,P=0.023)是OS的独立预后因素。结论脑转移数目越多VMAT技术剂量学优势越显著;KPS高、NLR值低的患者预后更佳。靶向治疗有助于延长IPFS和OS。     

EGFR基因突变型与野生型非小细胞肺癌脑转移预后的病例对照研究

目的：探讨表皮生长因子受体（epidermal growth factor receptor,EGFR）基因突变与非小细胞肺癌（non-small cell lung cancer,NSCLC）伴脑转移患者预后的相关性,为改善NSCLC合并脑转移患者预后、指导个体化治疗提供临床依据。方法：回顾性分析福建省立医院2013年1月1日至2018年9月30日期间收治的88例NSCLC合并脑转移患者的临床资料,随访取得患者的死亡时间,随访截止日期为2019年10月31日。收集和分析的临床资料包括性别、年龄、吸烟史、病理类型、基因检测、治疗情况、无进展生存期（progression free survival,PFS）、总生存期（overall survival,OS）等。运用生存分析（Kaplan-Meier生存时间曲线）评价EGFR突变型患者的预后,以单因素分析（log-rank检验）预测影响EGFR-TKI治疗效果的因素。结果：88例NSCLC脑转移患者有57例为EGFR突变型,其中位PFS（MPFS）为13.0个月（95%CI：11.951~14.049）,明显高于EGFR野生型患者（P=0.003）,患者中位生存期（median survival time,MST）为29.0个月（95%CI：20.531~37.468）,明显高于EGFR野生型（P=0.001）。EGFR突变型中,Exon19-del突变组患者较Exon21 L858R突变组患者OS有延长趋势（P=0.05）,Exon19-del+Exon20T790M突变组患者OS较Exon21 L858R突变组有延长趋势（P=0.077）。结论：EGFR突变组较野生型组NSCLC脑转移患者预后相对好些,且携带19外显子单一缺失突变的患者预后最好。     

全脑放疗联合SIB或SRS对小细胞肺癌脑转移患者的疗效分析北大核心CSCD

目的分析全脑放疗(WBRT)联合同步加量放疗(SIB)或联合序贯立体定向放射外科(SRS)在小细胞肺癌(SCLC)脑转移(BM)患者中的治疗价值。方法回顾性分析2007—2023年于天津医科大学肿瘤医院就诊的135例SCLC伴BM的患者。所有患者均接受了含铂方案一线化疗和WBRT,94例接受了胸部放疗。按BM放疗方式分为WBRT+SIB组(66例)和WBRT+SRS组(69例),经倾向评分匹配(PSM)后两组各63例。主要观察终点为总生存(OS)期、脑转移相关局部控制(BMRLC)率。采用卡方检验对性别、年龄等分类数据进行比较,采用Kaplan-Meier方法计算OS与BMRLC,WBRT+SIB与WBRT+SRS两组间生存曲线比较采用log-rank检验,用Cox多因素回归分析评估影响患者OS与BMRLC的风险因素。结果中位随访时间为24.9(6.30~109.57)个月,2年OS与BMRLC率分别为49.0%和85%,2例患者出现脑坏死。多因素分析提示,诊断后出现脑转移时间间隔≤10个月(P=0.041)、颅外进展控制(P=0.029)、诊断特异性预后评估分级(DS-GPA)评分≥2分(P=0.006)能显著改善OS。PSM后,WBRT+SIB组比WBRT+SRS组的2年OS率明显升高(P=0.041),而2年BMRLC率未有显著提高(P=0.203)。在DS-GPA评分<2分亚组,WBRT+SIB组OS明显高于WBRT+SRS组(P=0.016),两组BMRLC率无明显差别(P=0.205);在DS-GPA评分≥2分亚组,WBRT+SIB组OS与WBRT+SRS组的差异无统计学意义(P=0.266);WBRT+SIB组BMRLC率显著低于WBRT+SRS组(P=0.027)。结论WBRT+SIB比WBRT+SRS更适用于SCLC BM的患者,而对于DS-GPA评分≥2分者,WBRT+SRS的局部控制率更高。     

EGFR突变肺腺癌发生脑转移风险与预测

目的 探讨表皮生长因子受体(EGFR)突变肺腺癌发生脑转移的独立影响因素,建立脑转移发生预测模型,并应用决策曲线分析判断该模型临床决策能力,从而提高脑转移的防治。方法 回顾性分析2015-01-01-2020-12-31烟台毓璜顶医院首诊未发生脑转移的149例肺腺癌患者临床资料。进行二分类logistic回归分析,评估脑转移发生的独立影响因素,建立EGFR突变肺腺癌脑转移的预测模型。同时绘制受试者工作特征曲线下面积(AUC)和校正曲线,来验证模型的区分度和准确度。最后绘制决策曲线,量化预测模型中对应阈值内的净获益率,评估临床获益情况。结果 logistic回归分析发现,癌胚抗原(CEA)≥5.92 mg/L(OR=3.553,95%CI:1.314～10.341,P=0.015)、突变类型为19缺失(OR=5.219,95%CI:1.595～19.210,P=0.009)、颅外转移个数为2个(OR=34.802,95%CI:1.864～1 031.764,P=0.026)和颅外转移≥3个(OR=141.090,95%CI:4.989～8 451.359,P=0.008)是发生脑转移的独...     

局部增量照射无益于全脑照射SCLC脑转移患者生存再提高

目的 探讨局部增量照射(Boost)能否提高WBRT对小细胞肺癌脑转移(SCLC-BM)患者的OS和无颅内进展生存。方法 回顾分析2013—2015年首次诊治SCLC-BM 166例。除外PCI史(16例)或SRT (10例)或单纯局部脑照射(1例),入组142例。利用Kaplan-Meier法计算生存率Logrank法检验和单因素预后分析,Cox模型多因素预后分析。结果 平均年龄59.6岁,女性23%,脑转移灶数目分别为1(35%)、2~3(23%)、≥4(42%),化疗70%。中位OS期9.0个月、无颅内进展生存7.3个月。无照射(53例)、单纯WBRT (33)和WBRT+Boost (56)累计死亡率依次为92%、79%和73%;累计失败(死亡或颅内病灶未控)率为94%、82%和80%;与无照射相比,以上放疗模式对OS有影响(P=0.000、0.000),无颅内进展生存也有影响(P=0.000、0.000)。与单纯WBRT相比,WBRT+Boost对OS无影响(P=0.41、0.51)。结论 WBRT提高SCLC脑转移患者OS和无颅内进展生存,但同期或后续Boost照射无益于再提高生存。     

乳腺癌脑转移放疗的临床疗效和预后分析

目的 观察乳腺癌脑转移的放疗效果,探讨预后相关因素。方法 对接受全脑放疗的56例乳腺癌脑转移病例进行回顾性分析,所有患者均接受全颅放疗,放疗剂量为30 Gy/10Fx。采用Kaplan-Meier法计算总生存和中位生存时间,利用COX比例风险回归模型进行多因素分析患者预后的独立危险因素。结果 确诊乳腺癌脑转移平均年龄为57.9岁(32～82岁),平均随访时间为28.4个月(95%CI:11.6,49.2)。乳腺癌脑转移放疗患者中位生存时间为12.1个月(95%CI:8.7,15.5),1、2年生存率分别为52.6%、26.1%。单因素分析显示：有统计学意义的因素包括GPA评分、无颅外转移、脑转移时KPS评分、是否幕下转移、Her-2表达状态、分子分型、是否肺转移、脑转移放疗后化疗。多因素分析显示：脑转移时KPS(P=0.027)、GPA评分(P=0.036)、分子分型(P=0.042)、无颅外转移(P=0.028)、无肺转移(P=0.002)、脑转移放疗后接受化疗(P=0.034)是乳腺癌脑转移放疗患者预后的独立预后因素。结论 分子分型可作为乳腺癌脑转移的预后指标。脑转移放疗后化疗、无...     

不同基因分型晚期非小细胞肺癌患者的预后分析

背景与目的 非小细胞肺癌(non-small cell lung cancer,NSCLC)已由原来的组织分型指导下的治疗转变为基因分型指导治疗的模式,表皮生长因子受体(epidermal growth factor receptor,EGFR)和间变性淋巴瘤激酶(anaplastic lymphoma kinase,ALK)是肺癌最重要的两个驱动基因.本研究旨在探讨不同基因分型的复发或转移晚期NSCLC患者的临床特点及预后影响因素.方法 回顾性分析北京胸科医院2004年7月-2015年12月间553例EGFR和ALK基因状态明确的晚期NSCLC患者的临床资料,采用Cox比例风险回归模型对患者预后的独立影响因素进行分析.结果 553例细胞学或组织学证实的晚期NSCLC患者,EGFR突变患者227例,ALK阳性患者58例,EGFR和ALK双突变患者2例,EGFR和ALK野生型患者266例.227例EGFR突变患者的中位生存期(overall survival,OS)为28.7个月(95%CI:22.160-35.240),体能状态(performance status,PS)评分为0分-1分(HR=4.451;95%CI:2.112-9.382;P<0.001)、接受EGFR-酪氨酸激酶抑制剂(tyrosine kinase inhibitors,TKIs)靶向治疗(HR=2.785;95%CI:1.871-4.145;P<0.001)是EGFR突变患者生存的独立影响因素.58例ALK阳性患者的中位OS为15.5个月(95%CI:10.991-20.009),接受克唑替尼靶向治疗(P=0.022)是ALK阳性患者生存的独立影响因素.266例野生型患者的中位OS为12.1个月(95%CI:10.660-13.540),PS评分为0分-1分(HR=2.313;95%CI:1.380-3.877;P=0.001)、接受化疗(HR=1.911;95%CI:1.396-2.616;P<0.001)是野生型患者生存的独立影响因素.结论 不同基因型的晚期NSCLC患者的预后差异较大,靶向治疗可改善EGFR突变、ALK阳性患者生存.     

甲磺酸奥希替尼治疗EGFR基因突变型非小细胞肺癌脑转移的疗效评价

目的:探讨甲磺酸奥希替尼治疗表皮生长因子受体(epidermal growth factor receptor,EGFR)基因突变型非小细胞肺癌(non-small-cell lung cancer,NSCLC)脑转移的临床效果及预后因素.方法:回顾分析2017年5月-2019年12月60 例由蚌埠医学院第一附属医院肿...     

Radiotherapy in lung adenocarcinoma with brain metastases: effects of activating epidermal growth factor receptor mutations on clinical response.

PURPOSE: Whole-brain radiation therapy (WBRT) has been applied to inoperable brain metastases in lung adenocarcinoma. Recently, an in vitro study showed reduced clonogenic survival of mutant epidermal growth factor receptor (EGFR) lung cancer cell lines in response to ionizing radiation compared with that of the wild type. To elucidate the role of EGFR mutations in radiation treatment, we evaluated the clinical response to WBRT and survival of lung adenocarcinoma patients with brain metastases. EXPERIMENTAL DESIGN: This was a retrospective analysis of 63 patients with brain metastases from lung adenocarcinoma who were treated with WBRT. Demographic data, EGFR mutation status, response to WBRT, and survival data were collected. Clinical response was assessed 1 month after the start of WBRT. Univariate and logistic regression models were used to test potential predictive factors associated with clinical response. Log-rank test and Cox regression were analyzed to identify factors that affected survival. RESULTS: Clinical response to WBRT was observed in 29 patients (46%), with 34 nonresponder patients (54%). Patients with EGFR mutations had higher response rates to WBRT compared with those with the wild-type (54% versus 24%; P = 0.045). Both the administration of EGFR tyrosine kinase inhibitor (P = 0.034) and EGFR mutation (P = 0.029) were independently associated with response to WBRT. In Cox regression analysis, WBRT responder (P = 0.010) and absence of extracranial metastases (P = 0.002) were associated with better survival. CONCLUSIONS: Both the EGFR mutations and the administration of EGFR TKI during WBRT were independent predictors of response to WBRT in brain metastases of lung adenocarcinoma.     

Maximize surgical resection beyond contrast-enhancing boundaries in newly diagnosed glioblastoma multiforme: is it useful and safe? A single institution retrospective experience

The aim of this study was to analyze prognostic factors and evaluate the value of four prognostic scores including RPA, DS-GPA BS-BM, GGS for the EGFR mutant BM patients from lung adenocarcinoma treated with EGFR-TKI. Data of NSCLC were retrospectively reviewed from August 2010 to June 2015 using the medical database of Shanxi Provincial Cancer Hospital. Patients with BM from lung adenocarcinoma with mutant EGFR treated by EGFR-TKI or a combination of EGFR-TKI and WBRT were included. Potential prognostic factors were statistically examined. The C-index of each prognostic score was calculated. A total of 1063 BM patients with lung adenocarcinoma that had been identified with EGFR mutations were reviewed. A total of 104 patients that had been diagnosed with BM were confirmed to have mutant EGFR in primary tumors. These patients received treatment with EGFR-TKI or EGFR-TKI with WBRT to BM. The potential predictive factors in multivariable analysis included KPS (70 vs.70–80 vs. 90–100) and number of brain metastatic lesions. In the log-rank test, the indexes of RPA, DS-GPA BS-BM, and GGS were all significant predictors of OS. The C-indexes of each prognostic score were 0.79, 0.76, 0.77, and 0.74 in DS-GPA, RPA, GGS, and BS-BM, respectively. The indexes of RPA, DS-GPA BS-BM, GGS were applicable for asessing survival stratification in brain metastases from lung adenocarcinoma with presented EGFR mutations in our independent population. The DS-GPA appears to be the best predictive value. However, all four of the indexes could not evaluate the exact independent prognostic factors in multivariable analysis. A prognostic index specific for this group of patients was needed for targeted lung cancer therapy.     

Evaluation of 2 whole-brain radiotherapy schedules and prognostic factors for brain metastases in breast cancer patients

BACKGROUND: The majority of breast cancer patients with brain metastases receive whole-brain radiotherapy (WBRT) and have a survival of only a few months. A short WBRT regimen would be preferable if it provides survival that is similar to that achieved with longer programs. This retrospective study compared survival and local control within the brain resulting from short-course WBRT with longer programs in 207 breast cancer patients. METHODS: Sixty-nine patients treated with 5 fractions of 4 grays (Gy) each given within 5 days were compared with 138 patients treated with 10 fractions of 3 Gy each given over 2 weeks or 20 fractions of 2 Gy each given over 4 weeks. Six additional potential prognostic factors were investigated: age, Karnofsky performance score (KPS), number of brain metastases, the presence of extracranial metastases, interval from tumor diagnosis to WBRT, and recursive partitioning analysis (RPA) class. RESULTS: On univariate analysis, the WBRT regimen was not found to be associated with survival (P=.254) or local control (P=.397). Improved survival was associated with a KPS>70 (P<.001), single brain metastasis (P=.023), the absence of extracranial metastases (P<.001), and lower RPA class (P<.001). On multivariate analysis, which was performed without RPA class because this is a confounding variable, KPS (relative risk [RR] of 4.00; P<.001) and the presence of extracranial metastases (RR of 1.54; P=.024) maintained statistical significance. On univariate analysis, local control was associated with KPS (P<.001) and RPA class (P<.001). On multivariate analysis, local control was found to be associated with a KPS>70 (RR of 5.75; P<.001). CONCLUSIONS: Short-course WBRT with 5 fractions of 4 Gy each resulted in survival and local control that were similar to longer programs in breast cancer patients with brain metastases. The dose of 5 fractions of 4 Gy each appears preferable for the majority of these patients because it is less time consuming and more convenient.     

非小细胞肺癌脑转移患者全脑放疗不同剂量预后分析

目的:分析非小细胞肺癌(NSCLC)脑转移患者不同全脑放疗(WBRT)剂量的预后及影响因素。方法:回顾性分析2013—2015年间于河北医科大学第四医院行WBRT的244例NSCLC脑转移患者。按照不同WBRT剂量(EQD 2Gy)分为30~39 Gy组104例、≥40 Gy组140例。比较两组患者颅内无进...     

吉非替尼同步γ射线立体定向外科加全脑放疗治疗非小细胞肺癌脑转移瘤的临床研究

评价吉非替尼同步伽马射线立体定向外科加全脑放疗治疗非小细胞肺癌（NSCLC）脑转移瘤的作用和获益影响因素。方法：回顾性分析23例NSCLC脑转移瘤患者接受吉非替尼同步γ射线立体定向外科治疗加全脑放疗后的疗效、疾病进展时间、总生存时间、预后影响因素及不良反应。结果：颅内病灶的疗效为：CR 2例,PR 16例,SD 3例,PD 2例,有效率78.3%（18/23）,疾病控制率91.3%（21/23）。全身病变的总体疗效为：CR 0例,PR 5例,SD 12例,PD 6例,有效率21.7%（5/23）,疾病控制率73.9%（17/23）。中位疾病进展时间为8.3个月,中位生存时间为12.8个月。单因素分析显示：KPS评分、肿瘤累及体积、病理类型、RPA分级为疾病进展时间预测因素（P均<0.05）;而KPS评分、肿瘤累及体积、RPA分级则是生存时间预测因素（P均<0.05）。吉非替尼不良反应主要为Ⅰ~Ⅱ度皮疹和腹泻,患者均可耐受。结论：吉非替尼同步γ射线立体定向外科治疗加全脑放疗后的治疗NSCLC脑转移瘤,有效率和疾病控制率高,具有较长的中位疾病进展时间和生存时间,不良反应轻微,是一种很有价值的治疗方法。其中,KPS评分、肿瘤体积、病理类型（腺癌）、RPA分级是影响获益和生存的重要因素。     

乳腺癌脑转移全脑放疗预后及预后指数分析

目的 探讨乳腺癌脑转移患者全脑放疗(WBRT)预后以及不同预后指数差别。
方法 对2006-2010年间接受WBRT的99例乳腺癌脑转移患者进行Logrank法单因素与Cox法多因素预后分析,计算并比较RPA、GPA、BSBM、Rades、Carsten预后指数评分的敏感性和特异性。
结果 全组患者中位随访时间49个月,中位生存期为10个月。单因素分析显示年龄、脑转移时卡氏评分、是否伴有颅外转移、原发肿瘤控制情况、脑转移数目和WBRT后全身治疗与总生存相关(χ²=0.00~55.51,P=0.013~0.000),多因素分析证实卡氏评分<70和WBRT后全身治疗与总生存相关(χ²=35.26、7.21,P=0.000、0.007)。RPA、GPA、BSBM、Rades、Carsten预后指数评分对预测生存期≤3个月乳腺癌脑转移患者的敏感性和特异性分别为100%和85%、95%和62%、95%和86%、95%和84%、95%和85%。
结论 乳腺癌脑转移患者WBRT后全身治疗可改善患者总生存。对预测生存期≤3个月患者敏感性最好的为RPA指数,特异性最好的为BSBM指数。