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[目的]探讨脑转移瘤患者的合理治疗模式。[方法]回顾性分析330例脑转移瘤患者的临床资料,根据不同治疗方法进行分组,比较各组患者的中位生存期;并分析预后的影响因素。[结果]综合治疗组与单一治疗组中位生存时间分别为19个月和6个月(P<0.01)。综合治疗组中3种治疗方式联合组与2种治疗方式联合组中位生存时间分别为29个月和12个月(P<0.01)。全身+局部治疗组与局部治疗组中位生存时间分别为21个月和6个月(P<0.01)。在全身+局部治疗组中3种治疗方式联合与2种治疗方式联合中位生存时间分别为29个月和13个月(P<0.01)。分子靶向药物治疗组与非分子靶向治疗组中位生存时间分别为37个月和9个月(P<0.01)。年龄、原发肿瘤病理亚型为影响脑转移瘤患者预后的独立因素。[结论]脑转移瘤患者最佳的治疗模式为手术、放疗、化疗3种治疗方式联合治疗。具有分子靶向药物应用指征的患者,在原方案基础上联合分子靶向药物治疗效果更佳,但不同治疗方式的选择时机及联合方式尚需进一步研究。
[Objective] To explore the reasonable treatment mode of patients with brain metastases. [Methods] The clinical data of 330 patients with brain metastases were retrospectively analyzed. The patients were divided into groups according to different treatment methods. The median survival time of the patients in each group was compared. The influencing factors of prognosis were analyzed. [Results] The median survival time of combination therapy group and monotherapy group was 19 months and 6 months respectively (P <0.01). The median survival time was 29 months and 12 months (P <0.01) in the combined treatment group and the combination of the three treatment groups. The median survival time was 21 months and 6 months in the systemic + topical and local treatment groups, respectively (P <0.01). In the systemic + topical treatment group, the combined median survival time of the three treatments with the two treatments was 29 months and 13 months, respectively (P <0.01). The median survival time in molecular targeted drug therapy group and non-molecular target therapy group was 37 months and 9 months respectively (P <0.01). Age, primary tumor pathological subtypes are independent prognostic factors for patients with brain metastases. [Conclusion] The best treatment mode for patients with brain metastases is combination therapy of three kinds of therapies including surgery, radiotherapy and chemotherapy. Patients with indications for the use of molecular targeted drugs, the combination of molecular targeted drugs on the basis of the original program is better, but the timing and the combination of different treatment options need further study.