同期推量放射和全脑照射+三维适形放射序贯 治疗非小细胞肺癌脑转移瘤的疗效及影响预后因素分析

目的 研究同期推量放射和全脑照射+三维适形放射序贯治疗非小细胞肺癌脑转移瘤的临床疗效,并观察影响预后的因素,为临床诊疗提供依据.方法 选取2012年6月至2014年6月在我院行同期推量放射治疗的非小细胞肺癌脑转移瘤患者76例为观察组,另选取同期全脑照射+三维适形放射序贯治疗患者76例为对照组,两组均治疗4周,比较两组患者的临床疗效,并分析影响预后的因素.结果 观察组患者的完全缓解率为72.4%(55/76),明显高于对照组的44.7%(34/76),差异具有统计学意义(P<0.05);观察组患者的1年生存率、2年生存率和3年生存率分别为64.5%、31.6%、11.8%,均高于对照组的34.2%、19.7%、5.3%,差异均具有统计学意义(P<0.05);单因素和多因素分析结果均显示,肿瘤体积、原发病灶和转移情况、放疗方法是影响预后的因素(P<0.05).结论 同期推量放射治疗非小细胞肺癌脑转移瘤能提高治疗效果,延长患者生存期,肿瘤体积、原发病灶和转移情况、放疗方法是影响预后的因素.

Efficacy and prognostic factors of simultaneous radiotherapy and total brain irradiation plus three-dimensional conformal radiation therapy in treatment of non-small cell lung cancer with brain metastases

Objective To study the clinical efficacy of simultaneous radiotherapy and total brain irradiation plus three-dimensional conformal radiation therapies in treatment of non-small cell lung with cancer brain metastases, to observe the prognostic factors, and to provide the basis for clinical diagnosis and treatment. Methods A total of 76 pa-tients with non-small cell lung cancer with brain metastase, who admitted to our hospital and treated with simultaneous radiotherapyfrom June 2012 to June 2014, were selected as the observation group. At the same time, 76 patients with non-small cell lung cancer with brain metastase treated with total brain irradiation plus three-dimensional conformal radi-ation therapy were selected as the control group. The two groups were treated for 4 weeks. The clinical efficacy of the two groups was compared, and the factors influencing the prognosis were analyzed. Results The complete remission rate of the observation group was 72.4%(55/76), which was significantly higher than 44.7%(34/76) of the control group (P<0.05). The one-year survival rate, two-year survival rate and three-year survival rate of the observation group were 64.5%, 31.6%, 11.8%, respectively, which were significantly higher than 34.2%, 19.7%, 5.3%of the control group (P<0.05). Univariate and multivariate analysis showed that the tumor volume, primary lesion and metastasis, and radiothera-py were the prognostic factors (P<0.05). Conclusion Simultaneous radiotherapy for non-small cell lung cancer with brain metastases can improve the therapeutic effect and prolong the survival time of patients. The tumor volume, primary lesion and metastasis, and radiotherapy are the prognostic factors.