CAJ | 학술논문

目的：探讨伽玛刀治疗肺癌脑转移瘤近期疗效的影响因素。方法回顾性分析采用伽玛刀治疗肺癌脑转移瘤患者的临床资料，将年龄、性别、肺癌病理类型、转移瘤部位、转移瘤大小、转移瘤数目、是否颅外转移、治疗前 KPS 评分、治疗前 PRA 评分、原发灶与脑转移瘤诊断时间间隔等列为影响因素，通过术后3个月时 WHO 实体瘤评价标准评定术后近期疗效，采用卡方检验和非条件 Logistic 回归多因素分析探讨影响因素与近期疗效的关系。结果术后3个月时脑转移瘤完全缓解35例，部分缓解17例，无变化29例，进展16例。Pear-son 卡方检验显示原发肿瘤病理类型、转移瘤部位、治疗前 KPS 评分、治疗前 PRA 评分、原发灶与脑转移瘤诊断时间间隔等因素对疗效有显著性影响，非条件 Logistic 回归多因素分析显示病理类型、转移瘤部位、治疗前 KPS 评分、治疗前 PRA 评分是影响近期疗效的独立危险因素。结论有效的局部放射剂量是伽玛刀治疗脑转移瘤近期疗效的重要保证，高侵袭性不利于伽玛刀对肿瘤的局部控制。
목적：탐토가마도치료폐암뇌전이류근기료효적영향인소。방법회고성분석채용가마도치료폐암뇌전이류환자적림상자료，장년령、성별、폐암병리류형、전이류부위、전이류대소、전이류수목、시부로외전이、치료전 KPS 평분、치료전 PRA 평분、원발조여뇌전이류진단시간간격등렬위영향인소，통과술후3개월시 WHO 실체류평개표준평정술후근기료효，채용잡방검험화비조건 Logistic 회귀다인소분석탐토영향인소여근기료효적관계。결과술후3개월시뇌전이류완전완해35례，부분완해17례，무변화29례，진전16례。Pear-son 잡방검험현시원발종류병리류형、전이류부위、치료전 KPS 평분、치료전 PRA 평분、원발조여뇌전이류진단시간간격등인소대료효유현저성영향，비조건 Logistic 회귀다인소분석현시병리류형、전이류부위、치료전 KPS 평분、치료전 PRA 평분시영향근기료효적독립위험인소。결론유효적국부방사제량시가마도치료뇌전이류근기료효적중요보증，고침습성불리우가마도대종류적국부공제。
Objective It is to approach the influence factors on early therapeutic effect of Gamma Knife surgery for patients with brain metastases of pulmonary cancer. Methods The clinical characteristics of patients with brain metastases of pulmonary cancer undergoing Gamma Knife surgery were analyzed retrospectively. Age,gender,pathological type,position,size,quan-tity,extracranial metastases,KPS and PRA score before radiosurgery,and interval of diagnosis between primary lesion and brain metastases were analyzed as influencing factors. Therapeutic effect at 3 months after radiosurgery was evaluated by WHO solid tumor evaluation criteria,and then,chi - square test and non-condition Logistic regression analysis were employed to de-fine the relationship between the early therapeutic effect and factors. Results At 3 months after surgery,there were 35,17,29 and 16 cases with complete remission,partial remission,no change and progression respectively. Pathological type,position, KPS and PRA score before radiosurgery,interval of diagnosis between primary lesion and brain metastases were revealed as the factors significantly related to therapeutic effect by Pearson chi-square test. Then,pathological type,position,KPS and PRA score before radiosurgery were shown as independent predictors by the non-condition Logistic regression analysis. Conclusion Effective radiological dose play a predominant role influencing early therapeutic effects for Gamma Knife surgery treating brain metastases. High invasion is harmful to local controlling of neoplasm treated with Gamma Knife surgery.