基于增强MRI诊断并行全脑放疗的非小细胞肺癌脑转移预后分析

摘要

Background and objective Brain metastases are a common complication of lung cancer, occurring in 20%-40% of patients. The aim of this study is to explore prognostic factors in non-small cell lung cancer (NSCLC) in patients with brain metastases diagnosed by constrast-enhanced MRI after whole brain radiotherapy Methods TA retrospective review of clinical data from 241 NSCLC patients with brain metastases received whole brain radiotherapy from April 2007 to October 2008 was performed. A number of potential factors that might affect prognosis after irradiation were evaluated. The significance of prognostic variables in the survival resulted from univariate analysis by Kaplan-Meier combining with Log-rank test; and the multivariate analysis was obtained by Cox regression model. Results Median follow-up time for the survivors was 19.1 months. For all patients; the-median survival time (MST) was 8.7 months. By univariate analysis, female patients with KPS>70, no symptom when diagnosed with brain metastases; tumor controlled in the chest; and received more than 3 cycles of chemotherapy and combined target therapy were the important factors for overall survival. By multivariate analysis, female, tumors controlled in the chest; and combined target therapy were independent prognostic factors for NSCLC patients with brain metastases. Tumor controlled in the chest was the most important independent prognostic factor. Conclusion Gender; local tumor controlled, and combined target therapy significantly influenced NSCLC brain metastases diagnosed by constrast-enchanced MRI survival after whole brain radiotherapy%背景与目的,肺癌脑转移约占脑转移瘤的20%-40%.本研究旨在探讨基于增强MRI诊断并行全脑放疗的非小细胞肺癌(non-small cell lung cancer,NSCLC)脑转移的预后因索.方法,回顾性分析2007年4月-2008年10月241例NSCLC脑转移并接受全脑放疗的病例资料,采用Kaplan-Meier法计算生存率,Log-rank法进行单因素分析,Coxl回归分析进行多因素分析.结果,中位随访时间为19.1个月,全组中位生存时间为8.7个月.影响NSCLC脑转移生存的单因索包括女性、KPS (karnofsky performance score)>70分、脑转移无症状、胸内病变控制、化疗3周期以上及合并靶向治疗.多因素分析显示性别、随访截止时胸内病变控制状态、靶向治疗是影响NSCLC脑转移生存的独立预后因素.结论,对于基于增强MRI诊断并行全脑放疗的NSCLC脑转移患者,性别、胸内病变控制、靶向治疗是影响生存的独立预后因素.