梁 颖, 林勇斌①, 张 力, 王思愚①, 吴海鹰, 陈丽昆, 李明毅②, 徐光川, 戎铁华①, 何友兼. ⅢA 期非小细胞肺癌患者术后脑转移高危临床因素分析*[J]. 中国肿瘤临床, 2010, 37(21): 1232-1236. DOI: 10.3969/j.issn.1000-8179.2010.21.008
引用本文: 梁 颖, 林勇斌①, 张 力, 王思愚①, 吴海鹰, 陈丽昆, 李明毅②, 徐光川, 戎铁华①, 何友兼. ⅢA 期非小细胞肺癌患者术后脑转移高危临床因素分析*[J]. 中国肿瘤临床, 2010, 37(21): 1232-1236. DOI: 10.3969/j.issn.1000-8179.2010.21.008
shu
LIANG Ying1, LIN Yongbin2, ZHANG Li1, WANG Siyu2, WU Haiying1, CHEN Likun1, LI Mingyi3, XU Guangchuan1, RONG Tie-hua2, HE Youjian1. Clinical Predictive Factors for Brain Metastasis from Stage ⅢA Non-Small-Cell Lung Cancer after Surgery[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2010, 37(21): 1232-1236. DOI: 10.3969/j.issn.1000-8179.2010.21.008
Citation: LIANG Ying1, LIN Yongbin2, ZHANG Li1, WANG Siyu2, WU Haiying1, CHEN Likun1, LI Mingyi3, XU Guangchuan1, RONG Tie-hua2, HE Youjian1. Clinical Predictive Factors for Brain Metastasis from Stage ⅢA Non-Small-Cell Lung Cancer after Surgery[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2010, 37(21): 1232-1236. DOI: 10.3969/j.issn.1000-8179.2010.21.008
shu

ⅢA 期非小细胞肺癌患者术后脑转移高危临床因素分析*

Clinical Predictive Factors for Brain Metastasis from Stage ⅢA Non-Small-Cell Lung Cancer after Surgery

    摘要
  • 摘要: 目的：本文探讨完整切除ⅢA 期非小细胞肺癌（Non-small-cell lung cancer，NSCLC ）术后高危脑转移的临床特征，分析ⅢA 期NSCLC 患者行预防性脑放射的指征。方法：对193 例完整切除术后的ⅢA 期NSCLC 患者进行回顾性分析，观察术后是否出现脑转移对生存的影响，并分析患者的临床资料，找出ⅢA 期NSCLC 术后脑转移的高危临床因素。结果：全组患者的中位生存期为829（16～3092）天，累计1、2、3、4、5 年生存率分别为80.3％、54.8％、37.6％、29.7％和21.9％。整个病程出现脑转移的患者有67例（34.7%），第1、2、3 年脑转移发生率分别为15.0% 、31.5% 、40.1% 。终生有脑转移患者的总生存和无复发生存均明显差于终生无脑转移的患者（P=0.011 和P=0.0004），两者的中位生存期分别为700 天和928 天，终身是否出现脑转移是影响预后的重要独立因素（P=0.04，HR= 1.546，95％CI ：1.020～2.343）。 Cox 预后多因素回归分析发现影响脑转移的因素为术前血清学CEA 水平（P=0.014，HR= 2.152，95％CI ：1.169～3.963），是否鳞癌（P=0.021，HR= 0.400，95％CI ：0.184～0.873）。 结论：终身是否出现脑转移是影响预后的重要独立因素，ⅢA 期术后脑转移高危因素为术前血清学CEA 升高和病理类型为非鳞癌。

     

    Abstract: Objective: To evaluate clinical risk factors which can predict brain metastases after complete resection of stage ⅢA NSCLC and to determine the parameters that indicate Prophylactic Cranial Irradiation (PCI). Methods:This study analyzed193 patients with completely resected stage IIIA NSCLC by evaluating the effect of brain metastases on survival. This study also sought to determine the clinical risk factors for brain metastasis. Results: Participants' median survival time was 829 days. The 1-, 2-, 3-, 4-, and 5-year overall survival rates were 80.3%,54.8%,37.6%,29.7%, and21.9%, respec-tively. Of the 193 patients, 34.7% (67/193 ) developed brain metastases at some point after resection. The incidence of brain metastases within 1, 2, and 3 years after surgery was 15.0%,31.5%, and40.1%, respectively. Univariate and multi-variate analyses identified pre-operative serum CEA elevation ( P=0.014 , HR= 2.152 , 95% CI: 1.169 -3.963 ) and squamous cell carcinoma (P=0.021 , HR= 0.400 , 95% CI:0.184 ~0.873 ) as independent clinical risk factors for brain metastasis. Conclusion: Pre-operative serum CEA elevation and squamous cell carcinoma were found to be independent clinical risk factors for NSCLC metastasis to the brain.

     

    • HTML全文
    • 参考文献(0)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回