肺癌脑转移患者长期生存分析

目的评价肺癌脑转移手术后放疗、化疗及综合治疗的疗效，分析肺癌脑转移患者的生存率及中位生存期。方法对1994年10月至2005年12月收治的45例肺癌脑转移患者（7例进行脑转移灶次全切除手术），进行常规放疗，每周5次，1．8～2GY／次，共25次，4—5周完成，总量DT40-45GY；4例在照完全颅40GY后，给予局部缩野补量，1．4～2GY／次，共7～10次，分9—14d完成。全部患者均进行了化疗。常用药物为顺铂、依托泊甙、环磷酰胺、阿霉素、卡莫司汀、替尼？自苷、卡铂等，一般为2～6周期。结果1年生存率为46．7％，2年生存率为12．O％，3年生存率为2．4％。中位生存期为11个月。各组生存率比较：单纯脑转移组优于脑转移合并多部位转移组（P〈0．05）；手术后放化疗组优于非手术放化疗组（P〈0．01）；化疗≥4周期组优于〈4周期组（P〈0．05）；≥60岁组与〈60岁组比较差异无统计学意义（P〉0．05），生存率无明显差别。结论对单纯肺癌脑转移患者有手术适应证者或能耐受4周期化疗的患者，应积极采取综合治疗措施，以提高生存率。

Long term survival analysis of palteats with brain metastasis from lung cancer

Objective To evaluate the effect of the radiotherapy, chemotherapy after operation and combined therapy on brain metastasis from lung carcinoma,and to analyze the survival rate and median survival time of patients with brain metastasis from lung cancer. Methods From October 1994 to December 2005, 45 patients with brain metastasis from lung cancer were treated with the conventional radiotherapy for 4 to 5 weeks. Forty-three patients in whole brain and 2 patients in half brain were irradiated. All patients had a chemotherapy of 2 to 6 periods. Results The survival rate of 1 year was 46.7% , of 2 years was 12.0%, of 3 years was 2.4%. The median survival time was 11 months. The survival rates in the single brain metastasis group, the radio-chemotherapy after operation on the brain metastasis group,more than 4 periods of chemotherapy group were higher than that in the brain metastasis with more than 1 lesion group, the no-operation group, less than 4 periods of chemotherapy group respectively (all P <0.05),while more or less than 60 years groups had no significant difference( P >0.05). Conclusions For the patients of single brain metastasis of lung cancer,suited operation, and bearing 4 periods chemotherapy, the comprehensive treatments should be taken to increase the survival rate.