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目的探讨~1H磁共振波谱(~1H-MRS)在非小细胞肺癌(NSCLC)脑转移放疗疗效评价中的预测价值。方法接受立体定向放疗(SRT)联合全脑照射(WBRT)的56例NSCLC脑转移患者在治疗前应用~1H-MRS进行检查,测量Cho/Cr的比值,比较治疗前Cho/Cr比值高组与Cho/Cr比值低组间疗效的差异,分析~1H-MRS在NSCLC脑转移放疗疗效评价中的预测价值。结果治疗前Cho/Cr比值中位值为1.989。治疗前Cho/Cr比值高组(>1.989)1、3、5年生存率分别为29.3%(95%CI:11.3%~47.3%)、0%、0%,平均生存时间为9.77个月(95%CI:7.50~12.04个月)。Cho/Cr比值低组(<1.989)1、3、5年生存率分别为70.5%(95%CI:53.3%~87.7%)、22.3%(95%CI:6.6%~38.0%)、1.8%(95%CI:0~8.1%),平均生存时间为24.67个月(95%CI:17.69~31.66个月)。治疗前Cho/Cr比值高组与Cho/Cr比值低组比较平均生存时间有统计学差异(P<0.05)。结论 ~1H-MRS对NSCLC脑转移放疗的疗效评价具有预测价值,治疗前Cho/Cr比值高组预后差。
Objective To investigate the predictive value of ~1H magnetic resonance spectroscopy (~1H-MRS) in evaluating the efficacy of brain metastases in non-small cell lung cancer (NSCLC). METHODS: 56 patients with NSCLC brain metastases underwent stereotactic radiotherapy (SRT) combined with whole brain irradiation (WBRT) were examined by ~1H-MRS before treatment. The ratio of Cho/Cr was measured and the ratio of Cho/Cr before treatment was higher. The difference in efficacy between the groups with low Cho/Cr ratios was analyzed, and the predictive value of ~1H-MRS in the evaluation of brain metastases radiotherapy for NSCLC was analyzed. Results The median Cho/Cr ratio before treatment was 1.989. The survival rates of patients with high Cho/Cr ratio (>1.989) at 1, 3, and 5 years were 29.3% (95% CI: 11.3% to 47.3%), 0%, and 0%, respectively, and the average survival time was 9.77 months. 95% CI: 7.50 to 12.04 months). The 1-, 3-, and 5-year survival rates of the low Cho/Cr ratio (<1.989) were 70.5% (95% CI: 53.3% to 87.7%), 22.3% (95% CI: 6.6% to 38.0%), and 1.8%, respectively. (95% CI: 0 to 8.1%), with an average survival time of 24.67 months (95% CI: 17.69 to 31.66 months). The mean survival time was significantly different between the high Cho/Cr ratio group and the low Cho/Cr ratio group before treatment (P<0.05). Conclusion ~1H-MRS has predictive value in evaluating the therapeutic effect of NSCLC brain metastases radiotherapy. The prognosis of patients with high Cho/Cr ratio before treatment is poor.