脑转移癌全脑放疗相关认知功能损害的临床研究

摘要

目的：：探讨脑转移癌全脑放疗相关认知功能损害情况，以期提高临床诊治水平。方法：选取2010年5月-2013年5月65例脑转移癌患者为研究对象，以简易精神状态量表作为认知评估工具，对其放疗1-6个月进行总体认知评估，根据有无神经系统症状对患者放疗前后进行总体认知功能改变分析。结果：有无症状在性别、年龄、影响认知基础疾病、颅内转移数目、肿瘤最大直径、其他部位转移、既往化疗史中比较差异无统计学意义(P>0.05)；而在放疗前认知评分、既往靶向治疗、原发灶癌上比较差异有统计学意义(P<0.05)。疗效上，部分缓解发生率为27.69%，稳定发生率为41.54%，疾病进展发生率为30.77%，总有效率为69.23%；两者在基线、1、2个月MMSE评分比较差异有统计学意义(P<0.05)，而在3、4、5、6个月的MMSE评分比较差异无统计学意义(P>0.05)。结论：脑转移癌全脑放疗对认知功能有损害，放疗后认知功能损害最明显，其后有所恢复。%Objective:To explore cognitive impairment of the whole brain radiotherapy of brain metastases-relat-ed,in order to improve the clinical diagnosis and treatment. Methods:All 65 paitents of brain metastases from May 2010 to May 2013 were selected,and they were checked with mini-Mental State Examination after radiotherapy. Over-all cognitive assessment were analysised according to neurological symptoms before and after radiotherapy. Results:There were asymptomatic in gender,age,underlying diseases affecting cognition,the number of brain metastases,tumor diameter,the other parts of the transfer,the history of previous chemotherapy,the difference was not statistically signif-icant(P>0. 05). Radiotherapy before cognitive score,previous targeted therapy,difference was statistically significant (P<0. 05). Partial remission rate was 27. 69%,stable rate was 41. 54%,30. 77% incidence of disease progression, the total effective rate was 69. 23%;both at baseline MMSE scores between 1 and 2 months,the difference was statis-tically significance(P<0. 05),while the difference in MMSE score 3,4,5,6 months was not statistically significant(P>0. 05). Conclusion:Brain metastases whole brain radiotherapy on cognitive function impairment,cognitive dysfunc-tion after radiotherapy most obvious subsequently was restored.