摘要
目的评估伽玛刀治疗肺癌脑转移瘤患者的疗效,分析影响生存预后的相关因素。方法选取2016年5月至2020年6月接受伽玛刀治疗的81例肺癌脑转移瘤患者进行回顾性研究,随访后建立临床资料数据库。总生存期定义为从患者接受伽玛刀治疗到死亡或末次随访日期或第一次失访日期的时间间隔。使用Kaplan-Meier法计算患者中位生存期,6个月、1年、2年的生存率,并绘制生存曲线。通过log-rank检验行单因素生存分析,检验各因素组间生存率的差异。采用Cox回归模型行多因素分析影响生存预后的不同因素。结果所有患者均获得随访,截至末次随访日期,81例患者中36例死亡(44.44%),伽玛刀治疗后的中位总生存期为23(95%CI:14~26)个月。6个月、1年、2年的总生存率分别为82.84%、63.53%、43.35%。结合单因素和多因素分析结果,转移灶总体积(HR=1.158,95%CI:1.079~1.242,P<0.001)、年龄(HR=2.666,95%CI:1.257~5.657,P=0.0106)及边缘剂量(HR=0.392,95%CI:0.167~0.922,P=0.0318)是影响生存的预后因素。结论伽玛刀治疗肺癌脑转移瘤的效果显著,可提高患者的生存率、延长生存期。转移灶总体积≥16 cm^(3)、年龄≥70岁是预后不利因素,边缘剂量≥17 Gy是预后有利因素,且差异有统计学意义(P<0.05)。
Objective To evaluate the efficacy of gamma knife in the treatment of brain metastases from lung cancer and to analyze factors affecting survival.Methods A total of 81 patients with brain metastases from lung cancer who received gamma knife treatment during May 2016 and June 2020 were selected for a retrospective study,and a database was established after follow-up.Overall survival was defined as the period from the time receiving gamma knife to the date of death or end of follow-up or the first loss of follow-up.The 6-month,1-year and 2-year survival rate were calculated with Kaplan-Meier method,and the survival curve was plotted.The differences in survival rates were analyzed with Log-rank test.Factors affecting survival were analyzed with Cox multivariate regression.Results All patients were followed up,and 36 of the 81 patients died(44.44%)at the end of follow-up.The median overall survival was 23(95%CI:14-26)months.The 6-month,1-year and 2-year survival rate were 82.84%,63.53%and 43.35%,respectively.The total volume of metastases(HR:1.158,95%CI:1.079-1.242,P<0.001),age(HR:2.666,95%CI:1.257-5.657,P=0.0106),and marginal dose(HR:0.392,95%CI:0.167-0.922,P=0.0318)were factors affecting survival.Conclusion Gamma knife treatment of brain metastases from lung cancer is highly effective,and can improve patients'survival rates and prolong their survival time.The total volume of metastases≥16 cm^(3)and age≥70 years are adverse prognostic factors,and marginal dose≥17 Gy is a favourable prognostic factor(P<0.05).
作者
高中霞
张铭
樊明德
谭晨阳
王梦迪
王超
樊跃飞
丁守銮
王成伟
GAO Zhongxia;ZHANG Ming;FAN Mingde;TAN Chenyang;WANG Mengdi;WANG Chao;FAN Yuefei;DING Shouluan;WANG Chengwei(Department of Neurosurgery,The Second Hospital of Shandong University,Jinan 250033,Shandong,China;Institute of Medical Sciences,The Second Hospital of Shandong University,Jinan 250033,Shandong,China)
出处
《山东大学学报（医学版）》
CAS
北大核心
2022年第8期44-49,共6页
Journal of Shandong University:Health Sciences
基金
山东大学横向课题(山东大学技术合同编号12681806)
关键词
伽玛刀
立体定向放射外科
脑转移瘤
肺癌
生存
预后因素
Gamma knife
Stereotactic radiosurgery
Brain metastases
Lung cancer
Survival
Prognostic factors
