首页> 中文期刊> 《中国医学装备》 >伽玛刀联合全脑放射治疗对肺癌脑转移瘤近期疗效影响因素分析

伽玛刀联合全脑放射治疗对肺癌脑转移瘤近期疗效影响因素分析

         

摘要

Objective:To analyze follow-up information of patients with brain metastases of pulmonary cancer undergoing Gamma Knife combined with Whole Brain Radiotherapy.Methods:The recordings of patients with brain metastases of pulmonary cancer undergoing Gamma Knife combined with Whole Brain Radiotherapy were analyzed retrospectively. Age, gender, pathological type, position, size, quantity, extracranial metastases, KPS and PRA score before radiosurgery, and interval of diagnosis between primary lesion and brain metastases were analyzed as predictors. Theraperutic effect at 3 months following radiosurgery was evaluated by WHO solid tumor evaluation criteria, and then, chi-square test and non-condition logistic regression analysis were employed to define the relationship between the early therapeutic effect and factors.Results:therapeutic results at 3 months after surgery demonstrated that there were 25, 22, 33, and 26 cases with complete remission, partial remission, no change, and progression respectively. Pathological type, size, quantity, extracranial metastases, and KPS score before radiosurgery et al were revealed as the factors significantly related to therapeutic effect by Pearson chi-square test. Then, Pathological type and extracranial metastases were shown as independent predictors by the non-condition logistic regression analysis.Conclusion: Treated by Gamma Knife combined with Whole Brain Radiotherapy, therapeutic effects are mainly influenced by pathological type and extracranial metastases. High invasion is harmful to local controlling of neoplasm treated with Gamma Knife surgery.%目的:分析肺癌脑转移瘤患者经过伽玛刀联合全脑放射治疗的随访资料,探讨近期疗效的影响因素。方法:回顾性分析肺癌脑转移瘤采取伽玛刀联合全脑放射治疗患者病历,将年龄、性别、肺癌病理类型,转移瘤部位、大小、数目、是否颅外转移以及治疗前KPS评分、PRA评分、原发灶与脑转移瘤诊断时间间隔等列为影响因素,术后3个月时通过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回归多因素分析影响因素与近期疗效的关系。结果:在106例患者中,术后3个月时完全缓解25例,部分缓解22例,无变化33例,进展26例。病理类型、转移瘤大小、转移瘤数目、是否颅外转移及治疗前KPS评分等因素对疗效影响差异有统计学意义;病理类型和是否颅外转移是影响近期疗效的独立危险因素。结论:在伽玛刀联合全脑放射治疗下,肺癌脑转移瘤患者的近期疗效主要受到原发肿瘤病理类型和是否存在颅外转移病灶影响,高侵袭性不利于肿瘤的局部控制。

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