肺腺癌脑膜转移患者的预后分析

发布时间：2018-05-24 12:22

本文选题：癌 + 非小细胞肺　；参考：《肿瘤》2017年04期

【摘要】：目的:探讨肺腺癌脑膜转移患者的生存情况及预后相关因素。方法:回顾性分析65例随访资料完整的肺腺癌脑膜转移患者的生存情况及预后相关因素。结果:65例患者的中位生存期为7.4个月,1年生存率为6.2%(4/65)。单因素分析结果显示,性别、年龄、吸烟史、脑膜转移时间及是否合并脑转移与总生存无显著相关性(P值均0.05),美国东部肿瘤协作组(Eastern Cooperative Oncology Group,ECOG)体能状况(performance status,PS)评分、是否接受脑室-腹腔(ventriculo-peritoneal,V-P)分流手术、表皮生长因子受体-酪氨酸激酶抑制剂(epidermal growth factor receptortyrosine kinase inhibitor,EGFR-TKI)靶向治疗、全身化疗(systemic chemotherapy,SC)、全脑放疗、脑膜转移时的临床症状和EGFR基因状态与总生存显著相关(P值均0.05)。多因素分析结果显示,EGFR基因状态、ECOG PS评分、SC和是否接受V-P分流手术是肺腺癌脑膜转移患者的独立预后因素(P值均0.05)。结论:肺腺癌脑膜转移患者的总体预后较差,其中EGFR基因突变患者的预后相对较好;EGFR-TKI靶向治疗、SC和V-P分流手术有助于延长肺腺癌脑膜转移患者的生存期,改善其预后。
[Abstract]:Objective: to investigate the survival and prognostic factors of patients with meningeal metastasis from lung adenocarcinoma. Methods: the survival and prognostic factors of 65 patients with meningeal metastasis from lung adenocarcinoma were retrospectively analyzed. Results the median survival time of 65 patients was 7.4 months and the 1 year survival rate was 6. 2 / 65. The results of univariate analysis showed that gender, age, smoking history, meningeal metastasis time and brain metastasis had no significant correlation with total survival (P = 0.05). Whether or not to undergo ventricular / peritoneal ventriculo-peritoneal V-P shunt, epidermal growth factor receptortyrosine kinase inhibitor EGFR-TKI, systemic chemotherapy, whole brain radiotherapy, The clinical symptoms and EGFR gene status of meningeal metastasis were significantly correlated with total survival (P = 0.05). Multivariate analysis showed that EGFR gene status, ECOG PS score, SC and V-P shunt were independent prognostic factors in patients with meningeal metastasis of lung adenocarcinoma. Conclusion: the overall prognosis of patients with meningeal metastasis from lung adenocarcinoma is poor. The prognosis of patients with EGFR gene mutation is relatively good. Conclusion: EGFR-TKI targeted therapy of SC and V-P shunt surgery can prolong the survival time and improve the prognosis of patients with meningeal metastasis of lung adenocarcinoma.
【作者单位】：郑州大学人民医院肿瘤内科;郑州大学人民医院神经外科;郑州大学人民医院放射科;郑州大学人民医院放疗科;郑州大学人民医院胸外科;
【分类号】：R734.2

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