脑转移灶体积评估非小细胞肺癌脑转移行全脑放疗的预后分析

发布时间：2018-05-29 19:59

  本文选题：非小细胞肺癌 + 脑转移　； 参考：《广东医学》2017年07期

【摘要】：目的评价脑转移灶体积与接受单纯全脑放疗(whole brain radiotherapy,WBRT)的非小细胞肺癌(non-small cell lung cancer,NSCLC)脑转移患者预后的关系。方法回顾性分析2010年8月至2014年12月就诊于我院,并接受单纯WBRT的54例NSCLC脑转移患者,WBRT剂量为40 Gy/20 F。放疗前行脑部MRI检查,计算脑部转移灶体积,并分为小肿瘤组和大肿瘤组;放疗结束后3个月,复查脑部MRI评价近期疗效;治疗后每3个月复查MRI评价临床疗效直至疾病进展或死亡,比较两组患者的总生存期及1年生存率,同时对其预后影响因素进行分析。结果小肿瘤组(体积7.65 cm~3)和大肿瘤组(体积7.65 cm~3)的总体缓解率和疾病控制率差异无统计学意义(P0.05);全部患者的中位生存期为9.4个月,脑转移灶体积7.65 cm~3患者的1年生存率较体积7.65 cm~3患者明显降低(22.22%vs 51.85%,P=0.037)。多因素分析显示:肿瘤体积、PS评分是影响总生存的独立因素。结论脑内转移灶体积与接受单纯WBRT的NSCLC脑转移患者近期疗效无明显关系,但脑转移灶体积7.65 cm~3患者的总生存期明显缩短。
[Abstract]:Objective to evaluate the relationship between the volume of brain metastases and the prognosis of patients with non-small cell lung cancer (NSCLC) who received whole brain radiotherapy. Methods from August 2010 to December 2014, 54 patients with brain metastases from NSCLC received WBRT. The dose of WBRT was 40 Gy/20 F. Brain MRI was performed before radiotherapy and the volume of brain metastases was calculated and divided into small tumor group and large tumor group. After treatment, MRI was reexamined every 3 months to evaluate the clinical efficacy until the disease progression or death. The total survival time and 1 year survival rate were compared between the two groups, and the prognostic factors were analyzed. Results there was no significant difference in overall remission rate and disease control rate between small tumor group (volume 7.65 cm ~ (-3) and large tumor group (volume 7.65 cm ~ (-3), and the median survival time of all patients was 9.4 months. The 1-year survival rate in patients with brain metastases at 7.65 cm~3 was significantly lower than that in patients with volume 7.65 cm~3. Multivariate analysis showed that tumor volume and PS score were independent factors affecting total survival. Conclusion there is no significant relationship between the volume of brain metastases and the short-term curative effect of patients with NSCLC brain metastases receiving WBRT alone, but the total survival time of 7.65 cm~3 patients with brain metastases is significantly shortened.
【作者单位】： 中山大学孙逸仙纪念医院放疗科;
【分类号】：R734.2;R730.55
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本文编号：1952199