手术切除治疗NSCLC脑转移瘤的预后情况及影响因素分析

目的探讨手术切除治疗非小细胞肺癌(NSCLC)脑转移瘤的预后情况并分析其影响因素。方法选取79例外科手术治疗的NSCLC脑转移瘤患者,观察其术后转归情况及临床资料,对患者性别、年龄、KPS评分、病理类型、脑转移瘤大小、术后治疗方案等可能影响预后的因素进行单因素分析及Cox多因素分析。结果79例中67例术前存在神经系统症状,手术治疗后65例(97.01%)神经系统症状明显缓解或消失。79例NSCLC脑转移瘤患者1 a、2 a、3 a生存率分别为48.10%、21.52%、10.13%。单因素分析发现,KPS评分、术后放疗、靶向治疗、颅外转移和原发灶控制情况对患者术后生存期有显著影响(P<0.05);而患者年龄、性别、病理类型、肿瘤直径与术后生存期无明显影响(P>0.05)。Cox多因素分析发现,KPS评分、术后放疗、靶向治疗、颅外转移和原发灶控制情况是影响NSCLC脑转移瘤患者生存期的独立因素(P<0.05)。结论外科手术治疗能有效改善NSCLC脑转移瘤患者神经系统不良症状,影响术后患者生存时间的因素包括KPS评分、术后放疗、靶向治疗、颅外转移和原发灶控制情况。

Analysis of prognosis and influencing factors of surgical resection in treatment of brain metastatic tumor from NSCLC

Objective To explore the prognosis of surgical resection in treated brain metastatic tumor from non-small cell lung cancer(NSCLC)and analyze the influencing factors.Methods 79 patients with NSCLC brain metastases treated by surgery were selected and the postoperative outcomes and clinical data were observed.Univariate analysis and Cox multivariate analysis were performed on the patients'gender,age,KPS score,pathological type,size of brain metastatic tumor,postoperative treatment plan and other factors that may affect the prognosis.Results Among the 79 patients,67 had neurological symptoms before operation,and 65 had neurological symptoms relieved or disappeared after operation,accounting for 97.01%.The 1-year,2-year and 3-year survival rates of 79 patients with brain metastatic tumor from NSCLC were 48.10%,21.52%and 10.13%,respectively.Univariate analysis showed that KPS score,postoperative radiotherapy,targeted therapy,extracranial metastasis and primary focus control had significant effects on postoperative survival(P<0.05).However,the age,gender,pathological type,tumor diameter and postoperative survival had no significant influence on postoperative survival(P>0.05).Cox multivariate analysis showed that KPS score,postoperative radiotherapy,targeted therapy,extracranial metastasis and primary focus control were independent factors for affecting the survival of patients with brain metastatic tumor from NSCLC(P<0.05).Conclusion Surgical treatment can effectively improve the neurological adverse symptoms in patients with brain metastatic tumor from NSCLC.Factors influencing postoperative survival time include KPS score,postoperative radiotherapy,targeted therapy,extracranial metastasis and primary focus control.