论文部分内容阅读
目的:评估非小细胞肺癌合并孤立性脑转移患者接受外科治疗的有效性。方法:回顾分析本单位2001年至2011年间行脑部和胸部病灶联合切除的非小细胞肺癌孤立性脑转移患者临床及随访资料。结果:共计21例患者进行了孤立性脑转移病灶切除和后续的肺癌根治术,18例(86%)患者有纵隔淋巴结转移,其中N1淋巴结阳性8例,N2淋巴结阳性10例。中位生存期32个月(95%置信区间15～49个月),1年,2年和5年生存率分别为70%,43%,22%。对可能影响预后的指标进行单因素分析,提示淋巴结转移是影响预后的危险因素(P=0.002)。结论:对于非小细胞肺癌孤立性脑转移的患者,保证病灶完全切除和手术耐受性前提下,对胸部和脑部病灶应同时采取积极的外科治疗策略以获得最佳疗效。
PURPOSE: To evaluate the effectiveness of surgical treatment in patients with non-small cell lung cancer and isolated brain metastases. Methods: The clinical and follow-up data of patients with solitary brain metastasis of non-small cell lung cancer who underwent combined resection of brain and chest lesions from 2001 to 2011 in our unit were retrospectively analyzed. Results: A total of 21 patients underwent resection of solitary brain metastases and radical resection of lung cancer. 18 cases (86%) had mediastinal lymph node metastases, of which N1 was positive and 10 was N2. The median survival time was 32 months (95% confidence interval 15-49 months), and the 1-, 2- and 5-year survival rates were 70%, 43%, and 22%, respectively. Univariate analysis of the possible prognostic indicators suggested that lymph node metastasis was a risk factor for prognosis (P = 0.002). Conclusion: For patients with solitary brain metastasis of non-small cell lung cancer, under the premise of complete resection and surgical tolerance, positive surgical treatment strategies should be adopted for the chest and brain lesions in order to obtain the best therapeutic effect.