肺癌合并孤立性脑转移的外科治疗效果的分析

目的比较肺癌合并孤立性脑转移患者原发病灶切除及不同方法处理脑部转移灶的临床疗效。方法回顾性分析2004年1月至2008年6月在中山大学附属第一医院收治的37例非小细胞肺癌合并孤立性脑转移的患者的临床资料，其中21例患者接受开颅摘除脑转移瘤＋肺部原发灶的根治性切除治疗（开颅组）；16例患者接受γ-刀照射脑转移瘤＋肺部原发灶根治性切除治疗（γ-刀组）。观察两组患者治疗后的中位生存时间和1年生存率情况。结果中位随访时间20个月（18～26个月）。开颅组和γ-刀组的中位生存时间分别为11．8个月和12．6个月，1年生存率分别为57．14％（12／21）和56．25％（9／16），但两组的生存曲线无统计学意义（P〉0．05）。结论对于肺癌合并孤立性脑转移灶的患者应积极外科处理；至于脑部转移灶的处理，γ-刀的使用具有创伤小，疗程短的优越性。

Analysis of the Clinical Effect on Treatment of non-smal-cell Lung Cancer with Isolated Brain Metastasis

Objective To assess the therapeutic effect of non-sinai-cell lung cancer with isolated brain metastasis. Methods From January 2004 to June 2008, thirty-seven patients diagnosed as non-small-eel lung cancer with isolated cerebral metastasis received treatment in The First Affiliated Hospital of Sun Yet-sen Uni-versity. Some cases (21 peients)were treated with the craniotomy on brain metastasis and lung cancer resection, the other cases (16patients)were treated with the γ-ray stereotactic radiosurgery on brain metastasis and lung cancer resection. The median survival and one-year survival rate were analysed between the two groups. Results The cases were followed up for 18 to 26 months (median, 20 months). The median survival for craniotomygroup andγ-knffe group were 11.8 months and 12. 6 months, respectively,and the one-year survival rate were 57.14% ( 12/21 ) and 56. 25% ( 9/16), respectively ( P > 0. 05 ), while no significant difference was found be-tween the two curves of survival( P >0. 05 ). Conclusion The patients with non-smal-cell lung cancer with iso-lated brain metastases should be treated actively, meanwhile, it is mild trauma and short period of treatment that the isolated brain metastasis is treated with γ-knife.