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为了比较不同放疗方式对非小细胞肺癌(NSCLC)脑转移的疗效及预后影响因素,回顾性分析97例NSCLC脑转移患者的临床资料。23例接受全脑放疗2周30 Gy/10次(A组);45例接受全脑放疗4周40 Gy/20次(B组);29例接受全脑放疗4周40 Gy/20次,然后局部缩野加量1周10 Gy/5次(C组)。A组中位生存时间8.7个月,1年局部控制率为23%;B组中位生存时间8.8个月,1年局部控制率为63%;C组中位生存时间9.2个月,1年局部控制率为84%。3组中位生存时间差异均无统计学意义(P>0.05),但C组1年局部控制率明显高于A组。单因素分析表明,颅外转移及脑转移瘤个数是预后的危险因素;多因素Cox模型分析表明,颅外部位转移是预后的独立危险因素。初步研究结果提示,NSCLC脑转移的预后与颅外转移及脑转移瘤个数有关,颅外转移是影响预后的独立因素。
In order to compare the effect of different radiotherapy methods on brain metastasis of non-small cell lung cancer (NSCLC) and its prognostic factors, clinical data of 97 NSCLC brain metastases were retrospectively analyzed. Twenty-three patients received whole-brain radiotherapy for 30 weeks (Group A) for 30 weeks; 45 patients received 40 Gy/20 sessions (B group) for 4 weeks; and 29 patients received 40 Gy/20 sessions of 4 weeks for whole-brain radiotherapy. Then the local shrinkage was increased by 10 Gy/5 times (C). The median survival time in group A was 8.7 months, and the local control rate was 23% in one year; the median survival time in group B was 8.8 months, and the local control rate was 63% in one year; the median survival time in group C was 9.2 months, and 1 year. The local control rate is 84%. There was no significant difference in median survival time among the three groups (P>0.05), but the control rate in group C was significantly higher than that in group A in one year. Univariate analysis showed that the number of extracranial metastases and brain metastases was a risk factor for prognosis; multivariate Cox model analysis showed that extracranial metastasis was an independent risk factor for prognosis. The preliminary findings suggest that the prognosis of NSCLC brain metastases is related to the number of extracranial metastases and brain metastases. Extracranial metastasis is an independent factor that influences prognosis.