目的：探讨已接受全脑放疗的脑转移非小细胞肺癌患者生存的影响因素。方法收集72例经病理确诊的非小细胞肺癌患者的临床病理资料，采用COX风险回归模型分析患者各项临床数据与生存之间的关系。结果患者确诊脑转移后的中位生存期（MST）是8.0个月。多因素分析显示，接受全身性治疗（P=0.002），非鳞癌（P=0.038），ECOG评分﹤2分（P=0.001），1～3个脑转移灶（P=0.007）为脑转移非小细胞肺癌患者的独立预后因素。在EGFR状态未知的患者中，接受全身化疗或酪氨酸激酶抑制剂（EGFR-TKIs）的生存期差异没有统计学意义。结论接受全身性治疗是已接受全脑放疗的非小细胞肺癌脑转移患者的独立预后因素，EGFR状态未知的患者接收全身化疗或EGFR-TKIs治疗的生存期没有明显差异。%Objective To explore the influence of systemic therapy on survival after whole brain radiation therapy (WBRT) in non-small-cell lung cancer (NSCLC) patients with brain metastases (BM).Methods The data of 72 NSCLC patients with BM treated between January 2007 and December 2012 in the Afifliated Hospital of Jiangnan University was retrospectively reviewed. Multivariate analyses were carried out using the Cox's proportional hazards regression model.ResultsThe median survival time (MST) for patients with BM at initial diagnosis was 8.0 months. Multivariate analyses revealed that receiving systemic treatment (P=0.002), non-squamous NSCLC (P=0.038), good performance status (ECOG Score﹤2,P=0.001), 1-3 of brain metastases (P=0.007) were independent prognostic factors for overall survival. In EGFR unknown patients, no signiifcant difference of survival was found between patients receiving systemic chemotherapy or those receiving EGFR-TKIs.ConclusionReceiving systemic treatment was one of the independent prognostic factor for better survival of NSCLC patients with BM after WBRT treatment. For patients with unknown EGFR status, there was no signiifcant difference in overall survival between receiving systemic chemotherapy and EGFR-TKIs treatment.
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