现代肿瘤医学
現代腫瘤醫學
현대종류의학
JOURNAL OF MODERN ONCOLOGY
2014年
9期
2127-2131
,共5页
脑转移瘤%肺癌%伽玛刀%立体定向放射外科%生存%预后分析
腦轉移瘤%肺癌%伽瑪刀%立體定嚮放射外科%生存%預後分析
뇌전이류%폐암%가마도%입체정향방사외과%생존%예후분석
brain metastases%lung cancer%Gamma-knife%stereotactic radiosurgery%survival%prognostic analysis
目的：分析伽玛刀治疗肺癌脑转移瘤患者的生存及预后影响因素。方法：回顾性分析行伽玛刀治疗的56例肺癌脑转移瘤患者，单纯SRS组22例，单纯SRT组16例，联合全脑放疗（WBRT）组9例，行伽玛刀挽救组7例，行联合WBRT挽救组2例。Log rank法单因素分析影响预后的因素。结果：全组经治疗后6月、1年生存率分别为50％、10％，中位生存期为6个月。单纯SRS、单纯SRT、SRS联合WBRT、SRS/SRT挽救组、SRS＋WBRT挽救组6月生存率分别为59％、55％、40％、33％、0％，中位生存期分别为8、9、6、5、3个月（P＝0．005）。其中，SRS对SRT（P＝0．157）、SRS对SRS ＋WBRT（P＝0．551）、SRT对SRS ＋WBRT（P＝0．266）、SRS/SRT挽救组对SRS＋WBRT挽救组（P＝0．177）无统计学意义。单因素分析显示影响总生存率的因素有原发灶的控制情况、病理、中枢外转移情况、KPS评分、RPA分级、病灶所处位置、前期化疗、前期颅内治疗、病灶数目（P＝0．000、0．013、0．002、0．000、0．000、0．000、0．043、0．011、0．037）。多因素分析显示KPS评分、原发灶控制、病理、前期颅内处理影响生存（P＝0．000、0．005、0．006、0．002）。结论：用伽玛刀行单次SRS或分次SRT或与WBRT联合治疗在对生存获益上相似；KPS评分、原发灶控制情况、病理类型、前期颅内处理是影响生存的主要因素。
目的：分析伽瑪刀治療肺癌腦轉移瘤患者的生存及預後影響因素。方法：迴顧性分析行伽瑪刀治療的56例肺癌腦轉移瘤患者，單純SRS組22例，單純SRT組16例，聯閤全腦放療（WBRT）組9例，行伽瑪刀輓救組7例，行聯閤WBRT輓救組2例。Log rank法單因素分析影響預後的因素。結果：全組經治療後6月、1年生存率分彆為50％、10％，中位生存期為6箇月。單純SRS、單純SRT、SRS聯閤WBRT、SRS/SRT輓救組、SRS＋WBRT輓救組6月生存率分彆為59％、55％、40％、33％、0％，中位生存期分彆為8、9、6、5、3箇月（P＝0．005）。其中，SRS對SRT（P＝0．157）、SRS對SRS ＋WBRT（P＝0．551）、SRT對SRS ＋WBRT（P＝0．266）、SRS/SRT輓救組對SRS＋WBRT輓救組（P＝0．177）無統計學意義。單因素分析顯示影響總生存率的因素有原髮竈的控製情況、病理、中樞外轉移情況、KPS評分、RPA分級、病竈所處位置、前期化療、前期顱內治療、病竈數目（P＝0．000、0．013、0．002、0．000、0．000、0．000、0．043、0．011、0．037）。多因素分析顯示KPS評分、原髮竈控製、病理、前期顱內處理影響生存（P＝0．000、0．005、0．006、0．002）。結論：用伽瑪刀行單次SRS或分次SRT或與WBRT聯閤治療在對生存穫益上相似；KPS評分、原髮竈控製情況、病理類型、前期顱內處理是影響生存的主要因素。
목적：분석가마도치료폐암뇌전이류환자적생존급예후영향인소。방법：회고성분석행가마도치료적56례폐암뇌전이류환자，단순SRS조22례，단순SRT조16례，연합전뇌방료（WBRT）조9례，행가마도만구조7례，행연합WBRT만구조2례。Log rank법단인소분석영향예후적인소。결과：전조경치료후6월、1년생존솔분별위50％、10％，중위생존기위6개월。단순SRS、단순SRT、SRS연합WBRT、SRS/SRT만구조、SRS＋WBRT만구조6월생존솔분별위59％、55％、40％、33％、0％，중위생존기분별위8、9、6、5、3개월（P＝0．005）。기중，SRS대SRT（P＝0．157）、SRS대SRS ＋WBRT（P＝0．551）、SRT대SRS ＋WBRT（P＝0．266）、SRS/SRT만구조대SRS＋WBRT만구조（P＝0．177）무통계학의의。단인소분석현시영향총생존솔적인소유원발조적공제정황、병리、중추외전이정황、KPS평분、RPA분급、병조소처위치、전기화료、전기로내치료、병조수목（P＝0．000、0．013、0．002、0．000、0．000、0．000、0．043、0．011、0．037）。다인소분석현시KPS평분、원발조공제、병리、전기로내처리영향생존（P＝0．000、0．005、0．006、0．002）。결론：용가마도행단차SRS혹분차SRT혹여WBRT연합치료재대생존획익상상사；KPS평분、원발조공제정황、병리류형、전기로내처리시영향생존적주요인소。
Objective:To evaluate the survival and prognostic factors of Gamma -knife (GK)for patients with brain metastases(BM)from lung cancer.Methods:All 56 patients with BM after GK were retrospectively ananlyzed. Among them,there were 22 patients treated by stereotactic radiosurgery(SRS)alone,16 patients by stereotactic radio-therapy(SRT alone),9 patients by SRS combinated with whole brain radiotherapy(SRS +WBRT),7 patients were salvaged by SRS/SRT,2 patients salvaged by SRS+WBRT.Log rank method was used for univariate analyses.Cox regression model was used for multivariate analyses.Results:The 6 months and 1 year survival rate for all groups was 50%,10%,and median overall survival was 6 months.The 6 months survival rate for SRS alone group,SRT alonegroup,SRS +WBRT group,salvaged SRS /SRT group,and salvaged SRS +WBRT group were 59%,55%,40%,33%,0%,respectively.The median overall survival(MOS)were 8,9,6,5,3 months(P =0.005).Comparision a-mong groups,SRS vs SRT(P =0.157),SRS vs SRS +WBRT(P =0.551),SRT vs SRS +WBRT(P =0.266),sal-vaged SRS /SRT vs salvaged SRS +WBRT(P =0.177).The univariate analysis showed that the primary tumor con-trol,Histologicalal type,extra -cranial metastases disease,Karnofsky performance score(KPS),RPA class,site of le-sion,previous chemotherapy,previous intrcranial treatment,number of lessions were significant prognostic factors foroverall survival(P =0.000,0.013,0.002,0.000,0.000,0.000,0.043,0.011,0.037).The multivariate analysisshowed that the KPS score,primary tumor control,histologicalal type,previous intrcranial treatment were the independ-ent prognostic factors(P =0.000,0.005,0.006,0.002).Conclusion:There is no difference of survival among SRS,SRT and SRS +WBRT,even of salvage group for BMfrom lung cancer.KPS score,primary tumor control,histologicalaltype,previous intrcranial treatment were the independent prognostic factors for patients with BMfrom lung cancer.
