【摘要】 目的:探究全脑放射治疗(WBRT)对肺癌脑转移瘤患者近期神经认知功能及预后的影响，分析WBRT治疗肺癌脑转移的安全性。方法:采用回顾性研究方式，选取2017年1月至2021年10月于我院进行肺癌脑转移瘤治疗的患者91例，所有患者均行WBRT治疗，比较治疗前后患者近期神经认知功能。进行为期4个月门诊或电话随访观察，记录患者生存死亡状态，将其分为生存组、死亡组，用COX回归分析影响患者死亡的因素。结果:治疗前后患者神经认知功能有显著差异，治疗后患者语言记忆、视觉记忆、注意力、信息处理速度明显更好，差异有统计学意义(P<0.05)。91例患者实施WBRT治疗后，通过随访调查发现45例患者治疗后4个月内死亡，截止随访结束，46例患者处于存活状态，治疗后4个月病死率49.45%。与死亡患者相比，存活患者组织学分型中鳞癌与腺癌占比更大，小细胞癌占比小，出现颅外转移、深转移瘤以及原发肿瘤未控制占比更少，差异有统计学意义(P<0.05)。COX回归分析结果显示，组织学诊断、颅外转移情况、转移瘤深浅情况、原发肿瘤是否控制与肺癌脑转移患者治疗后预后情况关联有统计学意义(P <0.05)。结论:WBRT治疗可改善肺癌脑转移瘤患者神经认知功能，组织学诊断、颅外转移情况、转移瘤深浅情况、原发肿瘤是否控制是影响患者预后的危险因素。更多还原

【Abstract】 Objective: To explore the effect of whole brain radiotherapy( WBRT) on recent neurocognitive function and prognosis of patients with lung cancer brain metastasis,and to analyze the safety of WBRT in the treatment of lung cancer brain metastasis.Methods: A retrospective study was conducted with a selection of91 patients with lung cancer brain metastases treated in our hospital from January 2017 to October 2021. All patients were treated with WBRT. The recent neurocognitive function of patients before and after treatment was compared. A 4-month outpatient or telephone follow-up observation was conducted to record the survival and death status of patients. They were divided into survival group and death group. The factors affecting the death of patients were analyzed by Cox regression.Results: There were significant differences in neurocognitive function before and after treatment. After treatment,the speed of language memory,visual memory,attention,and information processing was significantly better( P <0.05). After 91 patients were treated with WBRT,45 patients died within 4 months after discharge through follow-up investigation. As of the end of follow-up,46 patients were in a state of survival,and the case fatality rate was 49.45% 4 months after discharge. Compared with the dead patients,the proportion of squamous cell carcinoma and adenocarcinoma was larger,the proportion of small cell carcinoma was smaller,and the proportion of extracranial metastasis,deep metastasis,and uncontrolled primary tumor was less in the surviving patients( P <0.05). Cox regression analysis showed that histological diagnosis,extracranial metastasis,depth of metastatic tumor,and control of primary tumor were significantly correlated with the prognosis of patients with brain metastasis of lung cancer after treatment( P <0.05). Conclusion: WBRT treatment improves the neurocognitive function of patients with brain metastasis from lung cancer. Histological diagnosis,extracranial metastasis,depth of metastasis,and control of primary tumor are the risk factors affecting the prognosis of patients.更多还原