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目的:探讨肺腺癌脑膜转移患者的生存情况及预后相关因素。方法:回顾性分析65例随访资料完整的肺腺癌脑膜转移患者的生存情况及预后相关因素。结果:65例患者的中位生存期为7.4个月,1年生存率为6.2%(4/65)。单因素分析结果显示,性别、年龄、吸烟史、脑膜转移时间及是否合并脑转移与总生存无显著相关性(P值均>0.05),美国东部肿瘤协作组(Eastern Cooperative Oncology Group,ECOG)体能状况(performance status,PS)评分、是否接受脑室-腹腔(ventriculo-peritoneal,V-P)分流手术、表皮生长因子受体-酪氨酸激酶抑制剂(epidermal growth factor receptortyrosine kinase inhibitor,EGFR-TKI)靶向治疗、全身化疗(systemic chemotherapy,SC)、全脑放疗、脑膜转移时的临床症状和EGFR基因状态与总生存显著相关(P值均<0.05)。多因素分析结果显示,EGFR基因状态、ECOG PS评分、SC和是否接受V-P分流手术是肺腺癌脑膜转移患者的独立预后因素(P值均<0.05)。结论:肺腺癌脑膜转移患者的总体预后较差,其中EGFR基因突变患者的预后相对较好;EGFR-TKI靶向治疗、SC和V-P分流手术有助于延长肺腺癌脑膜转移患者的生存期,改善其预后。
Objective: To investigate the survival and prognosis of patients with lung adenocarcinoma with meningeal metastasis. Methods: A retrospective analysis of 65 patients with follow-up data of complete lung cancer patients with meningeal metastasis and prognosis related factors. Results: The median survival of 65 patients was 7.4 months, and the 1-year survival rate was 6.2% (4/65). Univariate analysis showed no significant correlation between gender, age, smoking history, time to meningeal metastasis and brain metastasis and overall survival (P> 0.05). Eastern Cooperative Oncology Group (ECOG) (PS) score, whether to accept ventriculo-peritoneal (VP) shunt surgery or not, epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) The overall survival was significantly correlated with treatment, systemic chemotherapy (SC), whole brain radiotherapy, clinical symptoms of meningeal metastasis and EGFR status (all P <0.05). Multivariate analysis showed that EGFR status, ECOG PS score, SC and V-P shunt were independent prognostic factors in patients with lung adenocarcinoma with meningeal metastasis (all P <0.05). Conclusion: The overall prognosis of patients with lung adenocarcinoma with meningeal metastasis is poor, and the prognosis of patients with EGFR gene mutation is relatively good. EGFR-TKI targeted therapy, SC and VP shunt can prolong the survival of patients with lung adenocarcinoma with meningeal metastasis , Improve its prognosis.