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目的 :探讨肺癌脑转移以放疗为主的综合治疗的疗效及有关因素对预后的影响。方法 :对 1986年 6月～ 1996年 8月间我院收治的经头颅CT和 /或MRI检查、手术后病理证实的肺癌脑转移 69例进性回顾性分析。结果 :手术 +放疗 +化疗、手术 +放疗、放疗 +化疗的中位生存期分别为11个月、10 5个月及 8 5个月 ,1年生存率分别为 4 0 0 0 % ,4 0 0 0 %及 31 58% ,显著优于单纯手术组、单纯放疗组及单纯化疗组 (P <0 0 5)。原发灶控制、卡氏评分≥ 60分、仅有颅内转移病人的 1年生存率分别为 2 3 68%、2 5 0 0 %及 17 0 2 % ;原发灶未控制、卡氏评分 <60分、有颅外转移的病人 1年生存率分别为 2 4 4 %、0和 4 55% ,明显影响预后。结论 :肺癌脑转移的治疗中以放疗为主的综合治疗是一种比较合理的治疗方法 ,可延长生存期、提高疗效。
Objective: To investigate the effects of radiotherapy-based comprehensive therapy of lung cancer with brain metastasis and related factors on the prognosis. Methods: A retrospective analysis of 69 patients with brain metastases of lung cancer confirmed by pathology after head CT and / or MRI examination from June 1986 to August 1996 was performed. Results: The median survival time of operation + radiotherapy + chemotherapy, surgery + radiotherapy, radiotherapy + chemotherapy were 11 months, 105 and 85 months, respectively. The 1-year survival rates were 40.0% and 40% 0 0% and 31 58%, respectively, which were significantly better than that of surgery group, radiotherapy alone group and chemotherapy alone group (P <0.05). Primary control, Karnofsky’s score≥60, only one-year survival rates of intracranial metastases were 23 68%, 25 0% and 17 0 2% respectively. The primary tumor was not controlled and the Karnofsky’s score <60 points, 1-year survival rates of patients with extracranial metastases were 24.4%, 0 and 45.5%, significantly affect the prognosis. Conclusion: Radiotherapy-based comprehensive treatment of brain metastases of lung cancer is a reasonable treatment, which can prolong the survival and improve the curative effect.