新的预后指数模型GPA在肺癌脑转移中的应用分析

目的利用有效预测模型评价脑转移瘤患者的预后和制定相关治疗策略.对比分析新的预测模型GPA和2个预后模型在肺癌脑转移中的应用.方法回顾性分析昆明医科大学第三附属医院放疗中心2006年6月至2008年12月151例肺癌脑转移患者的临床资料,进行单因素分析后通过比例风险模型(Cox模型)进行多因素分析.生存分析采用Kaplan-Meier法并进行Log-rank时序检验.结果单因素分析显示患者的Karnofsky评分(KPS评分)、脑转移灶数目、有无颅外转移与肺癌脑转移患者生存期有影响(P<0.05).多因素分析显示Karnofsky评分、有无颅外转移与肺癌脑转移预后相关(P<0.05).将相关预后参数在不同预后模型中的生存情况进行统计分析(P<0.01),3个模型对肺癌脑转移预后都有一定的预测作用.结论 GPA作为一个新的预后模型,与RPA和BSBM相比都是有用的肺癌脑转移预测模型.

Application of New Prognostic Index GPA in Lung Cancer with Brain Metastases

Objective To evaluate the new Graded Prognostic Assessment(GPA)scale in a prospective validation study to compare it with two published prognostic indexes.Methods We reviewed the clinical data of 151 lung cancer patients with brain metastases in our hospital from June 2006 to December 2008.The multivariate analysis was performed with Cox’s proportion risk model.Survival analysis was compared with Kaplan-Meier method and log-rank test was used respectively.Statistical significance was defined as P<0.05.Results The single factor analysis showed that patients’ performance status,gender,the number of brain metastases,the absence or presence of extracranial metastases were related to survival period(P<0.05).The multivariate analysis indicated that patients’ performance status and the absence or presence of extracranial metastases were closely related to their prognosis(P<0.05).Conclusion Our data suggest that the new GPA index is a valid prognostic index as with RPA or BSBM for lung cancer with brain metastases.