CAJ | 학술논문

目的探讨乳腺癌脑转移患者全脑放疗(WBRT)预后以及不同预后指数差别.方法对2006-2010年间接受WBRT的99例乳腺癌脑转移患者进行Logrank法单因素与Cox法多因素预后分析,计算并比较RPA、GPA、BSBM、Rades、Carsten预后指数评分的敏感性和特异性.结果全组患者中位随访时间49个月,中位生存期为10个月.单因素分析显示年龄、脑转移时卡氏评分、是否伴有颅外转移、原发肿瘤控制情况、脑转移数目和WBRT后全身治疗与总生存相关(x2=0.00 ～55.51,P=0.013 ～0.000),多因素分析证实卡氏评分＜70和WBRT后全身治疗与总生存相关(x2=35.26、7.21,P=O.000、0.007).RPA、GPA、BSBM、Rades、Carsten预后指数评分对预测生存期≤3个月乳腺癌脑转移患者的敏感性和特异性分别为100％和85％、95％和62％、95％和86％、95％和84％、95％和85％.结论乳腺癌脑转移患者WBRT后全身治疗可改善患者总生存.对预测生存期≤3个月患者敏感性最好的为RPA指数,特异性最好的为BSBM指数.
목적 탐토유선암뇌전이환자전뇌방료(WBRT)예후이급불동예후지수차별.방법 대2006-2010년간접수WBRT적99례유선암뇌전이환자진행Logrank법단인소여Cox법다인소예후분석,계산병비교RPA、GPA、BSBM、Rades、Carsten예후지수평분적민감성화특이성.결과 전조환자중위수방시간49개월,중위생존기위10개월.단인소분석현시년령、뇌전이시잡씨평분、시부반유로외전이、원발종류공제정황、뇌전이수목화WBRT후전신치료여총생존상관(x2=0.00 ～55.51,P=0.013 ～0.000),다인소분석증실잡씨평분＜70화WBRT후전신치료여총생존상관(x2=35.26、7.21,P=O.000、0.007).RPA、GPA、BSBM、Rades、Carsten예후지수평분대예측생존기≤3개월유선암뇌전이환자적민감성화특이성분별위100％화85％、95％화62％、95％화86％、95％화84％、95％화85％.결론 유선암뇌전이환자WBRT후전신치료가개선환자총생존.대예측생존기≤3개월환자민감성최호적위RPA지수,특이성최호적위BSBM지수.
Objective To analyse the prognostic factors and 5 prognostic indices in breast cancer patients with brain metastases after whole-brain radiotherapy (WBRT).Methods Log-rank test (for univariate prognostic analysis) and Cox regression analysis (for multivariate prognostic analysis) were performed in 99 breast cancer patients with BM who received WBRT from January 2006 to February 2010.The sensitivities and specificities of prognostic indices,including recursive partitioning analysis (RPA),graded prognostic assessment (GPA),basic score for brain metastases (BSBM),Rades,and Carsten,were calculated and compared.Results The median follow-up was 49 months; the median survival was 10 months.The univariate analysis showed that age,Karnofsky performance score (KPS) at the diagnosis of BM,presence of extracranial metastases,primary tumor control,number of BM,and systemic treatment after WBRT were significantly correlated with overall survival (x2 =0.00-55.51,P =0.000-0.013).The multivariate analysis showed that KPS of ＜ 70 and systemic treatment after WBRT were significantly correlated with overall survival (x2 =35.26,P =0.000;x2 =7.21,P =0.007).In predicting ≤3 months of survival for breast cancer patients with BM,the sensitivities and specificities of RPA,GPA,BSBM,Rades,and Carsten were 100％ and 85％,95％ and 62％,95％ and 86％,95％ and 84％,and 95％ and 85％,respectively.Conclusions Systemic treatment after WBRT can improve overall survival in breast cancer patients with BM.In predicting ≤3 months of survival,RPA is the most sensitive index,and BSBM is the most specific index.