【摘要】 目的:对调强放射治疗技术和常规放射治疗技术治疗肺癌脑转移患者的生存时间进行分析,并研究影响肺癌脑转移患者预后的因素。方法:选取2010年10月-2015年3月于福建省肿瘤医院放疗科接受脑部放射治疗的54例肺癌脑转移患者,其中33例接受调强全脑放射治疗,21例接受常规全脑放射治疗,对寡转移灶(转移灶≤3个)患者行局部加量放疗1～2次,随访至2018年3月。生存时间为患者诊断为脑转移开始至死亡或随访结束时间,以月份为单位。应用Kaplan-Meier法进行生存分析,应用log-rank检验对肺癌脑转移患者预后单因素进行分析,应用Cox回归模型对肺癌脑转移患者预后多因素进行分析。结果:接受调强全脑放射治疗患者中位生存时间为16.0(7.5,35.5)个月,接受常规全脑放射治疗患者中位生存时间为12.0(6.5,18.0)个月,差异有统计学意义(P=0.028);放疗方式、颅外转移及病理类型是影响肺癌脑转移患者预后因素(P<0.05)。结论:与常规放射治疗技术相比,调强放射治疗技术可显著延长肺癌脑转移患者的生存时间,且放疗方式、病理类型和颅外转移是影响预后因素。更多还原

【Abstract】 Objective:To study the survival time of patients with brain metastasis of lung cancer treated by intensity-modulated radiotherapy and conventional radiotherapy,and study the factors that affect the prognosis of patients with brain metastasis of lung cancer.Method:From October 2010 to March 2015,54 patients with brain metastasis of lung cancer received brain radiotherapy in the radiotherapy department of Fujian Cancer Hospital were selected,33 of whom received intensity-modulated whole brain radiotherapy and 21 received conventional whole brain radiotherapy.Patients with oligometastases (≤3 metastases) received local dose radiotherapy 1-2 times,and followed up to March 2018.Survival time was the time from the beginning of brain metastasis diagnosed to the end of death or follow-up,and was measured in months.Kaplan-Meier method was used for survival analysis,and log-rank test was used to analyze the single factor of prognosis of patients with brain metastasis of lung cancer,and Cox regression model was used to analyze the multiple factors of prognosis of patients with brain metastasis of lung cancer.Result:The median survival time in patients receiving intensity-modulated whole brain radiotherapy was 16.0 (7.5,35.5) months,while the median survival time in patients receiving conventional whole brain radiotherapy was 12.0 (6.5,18.0) months,and the difference was statistically significant (P=0.028).Radiotherapy method,extracranial metastasis and pathological type were the prognostic factors of patients with brain metastasis of lung cancer (P<0.05).Conclusion:Intensity-modulated radiotherapy can significantly prolong the survival time of patients with brain metastasis of lung cancer compared with conventional radiotherapy.Radiotherapy method,pathological type and extracranial metastasis are the factors influencing the prognosis.更多还原