CAJ | 학술논문

目的：分析肺癌脑转移瘤行伽玛刀治疗患者的临床资料，探讨远期生存的影响因素。方法：收集132例肺癌脑转移瘤患者的临床资料，记录患者年龄、性别、肺癌病理类型、转移瘤的部位、大小、数目以及是否颅外转移，对治疗前卡氏性能量表(KPS)和概率风险评估(PRA)进行评分，同时记录原发灶与脑转移瘤诊断时间间隔等资料。采用log-rank方法进行远期生存的单因素分析，通过Cox回归模型进行多因素远期生存分析。结果：患者中位生存时间为22个月，12个月累计生存率为66.67%，24个月累计生存率为26.52%，36个月累计生存率为9.85%，48月累计生存率为1.52%。Log-rank统计分析显示，病理类型、转移瘤部位、转移瘤数目、是否颅外转移以及治疗前KPS和RPA评分等对伽玛刀术后远期生存影响差异有统计学意义。Cox回归模型显示，颅外转移和治疗前RPA评分是影响远期生存率的独立危险因素。结论：注重颅外肿瘤的控制，配合有效的伽玛刀治疗是改善肺癌脑转移瘤患者远期预后的关键所在。
목적：분석폐암뇌전이류행가마도치료환자적림상자료，탐토원기생존적영향인소。방법：수집132례폐암뇌전이류환자적림상자료，기록환자년령、성별、폐암병리류형、전이류적부위、대소、수목이급시부로외전이，대치료전잡씨성능량표(KPS)화개솔풍험평고(PRA)진행평분，동시기록원발조여뇌전이류진단시간간격등자료。채용log-rank방법진행원기생존적단인소분석，통과Cox회귀모형진행다인소원기생존분석。결과：환자중위생존시간위22개월，12개월루계생존솔위66.67%，24개월루계생존솔위26.52%，36개월루계생존솔위9.85%，48월루계생존솔위1.52%。Log-rank통계분석현시，병리류형、전이류부위、전이류수목、시부로외전이이급치료전KPS화RPA평분등대가마도술후원기생존영향차이유통계학의의。Cox회귀모형현시，로외전이화치료전RPA평분시영향원기생존솔적독립위험인소。결론：주중로외종류적공제，배합유효적가마도치료시개선폐암뇌전이류환자원기예후적관건소재。
Objective: To analyze the clinical characteristics of patients with brain metastases of pulmonary cancer undergoing Gamma Knife radiosurgery and discuss the influencing factors of long-term survival. Methods: The clinical characteristics of 132 cases with brain metastases of pulmonary cancer undergoing Gamma Knife surgery were collected retrospectively. Age, gender, pathological type, position, size, quantity, extracranial metastases, KPS and PRA score before radiosurgery, and interval of diagnosis between primary lesion and brain metastases were recorded. Log-rank method and Cox regression model were employed to perform univariate and multivariate analysis respectively for long-term survival. Results: Median survival time was 22 months and accumulative survival rate was 66.67%at 12 months, 26.52%at 24 months, 9.85%at 36 months, 1.52%at 48 months, respectively. Pathological type, position, quantity, extracranial metastases, KPS and PRA score before radiosurgery, et al were revealed as the factors significantly related to long-term survival by log-rank analysis. Then, extracranial metastases and PRA score before radiosurgery were shown as independent predictors for long-term survival by Cox regression model. Conclusion:Primary tumor controlling actively combined with effective Gamma Knife radiosurgery plays a predominant role to improve the long-term prognosis for patients with brain metastases of pulmonary cancer.