脑放疗时机的选择对非小细胞肺癌脑转移的疗效和生存期的影响

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摘要目的探讨非小细胞肺癌伴脑转移患者脑放疗的最佳时机及对患者疗效和生存期的影响。方法回顾性分析2013年7月～2015年1月在河北北方学院附属第一医院确诊为非小细胞肺癌伴脑转移的106例患者的临床资料，根据有无临床症状分为观察组（n = 54）与对照组（n = 52）。观察组在非小细胞肺癌伴脑转移后即开始进行脑放疗，而对照组则选择在脑转移后出现临床症状后开始脑放疗，观察两组患者的初始进展部位，并比较其疗效和预后。结果脑转移治疗后两组患者初始进展部位比较，差异有统计学意义（P ＜ 0.05）。两组患者近期疗效中客观缓解率与总有效率比较，差异均无统计学意义（P ＞ 0.05）。两组患者治疗期间不良反应情况主要表现为血液学毒性、消化道反应、乏力等，不良反应分级多处于Ⅰ/Ⅱ级，Ⅲ/Ⅳ级者较少，组间比较差异均无统计学意义（P ＞ 0.05）。两组患者均获随访，随访时间3～24个月，中位随访时间为13.5个月。治疗前两组患者生活质量评分比较，差异无统计学意义（P ＞ 0.05）；治疗后1年及2年，观察组生活质量评分均明显高于对照组，差异均有统计学意义（P ＜ 0.05）。结论及早行全脑放疗有助于延长非小细胞肺癌伴脑转移患者的生存期，而推迟脑放疗将对患者预后造成负面影响，应引起临床重视。

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	王喆原娜朱艳平

关键词 ：非小细胞肺癌, 脑转移, 脑放疗, 时机, 疗效, 生存期

Abstract：Objective To explore the best time of brain radiotherapy in patients of non-small cell lung cancer with brain metastases and its influence on the curative effect and survival time. Methods The clinical data of 106 patients diagnosed as non-small cell lung cancer accompanied by brain metastases in the First Affiliated Hospital of Hebei North University from July 2013 to January 2015 were analyzed retrospectively and they divided into the observation group (n = 54) and the control group (n = 52) according to the clinical symptoms. The observation group was carried out brain radiation after non-small cell lung cancer accompanied by brain metastases, while the control group was given brain radiotherapy after the clinical symptoms of brain metastasis. The initial progress parts of the patients were observed, the curative effect and prognosis were compared between the two groups. Results After the treatment of patients with brain metastases, there was statistically significant difference in the initial progress parts between the two groups (P ＜ 0.05). There were no statistically significant differences in the short term efficacy such as objective response rate and total effective rate (P ＞ 0.05). During the treatment period, the adverse reactions in the two groups were mainly hematological toxicity, gastrointestinal reaction and fatigue. The grade of adverse reactions was mostly in grade Ⅰ/Ⅱ level, Ⅲ/Ⅳ level was less, and there were no statistically significant differences between the two groups in Ⅰ/Ⅱ and Ⅲ/Ⅳ level (P ＞ 0.05). The patients were all followed up and the follow up time was 3-24 months, the median follow-up time was 13.5 months. Before treatment, there was no statistically significant difference in score of life quality between the two groups (P ＞ 0.05), after treatment for 1 year and 2 years, the score of life quality in the observation group were significantly higher than those in the control group, with statistically significant differences (P ＜ 0.05). Conclusion Early whole brain radiotherapy helps to prolong the survival time of patients with non-small cell lung cancer accompanied by brain metastases, delayed brain radiotherapy will have a negative impact on the prognosis of the patients, clinical attention should be focused on.

Key words： Non-small cell lung cancer Brain metastases Brain radiation Timing Efficacy Survival time

引用本文:

王喆原娜朱艳平. 脑放疗时机的选择对非小细胞肺癌脑转移的疗效和生存期的影响[J]. 中国医药导报, 2018, 15(16): 76-79.
WANG Zhe YUAN Na ZHU Yanping. The influence of the choice of proper time of brain radiotherapy on the curative effect and survival time of non-small cell lung cancer with brain metastases. 中国医药导报, 2018, 15(16): 76-79.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2018/V15/I16/76

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