發(fā)布時間：2018-05-24 12:22

  本文選題：癌 + 非小細(xì)胞肺�。� 參考：《腫瘤》2017年04期

【摘要】：目的:探討肺腺癌腦膜轉(zhuǎn)移患者的生存情況及預(yù)后相關(guān)因素。方法:回顧性分析65例隨訪資料完整的肺腺癌腦膜轉(zhuǎn)移患者的生存情況及預(yù)后相關(guān)因素。結(jié)果:65例患者的中位生存期為7.4個月,1年生存率為6.2%(4/65)。單因素分析結(jié)果顯示,性別、年齡、吸煙史、腦膜轉(zhuǎn)移時間及是否合并腦轉(zhuǎn)移與總生存無顯著相關(guān)性(P值均0.05),美國東部腫瘤協(xié)作組(Eastern Cooperative Oncology Group,ECOG)體能狀況(performance status,PS)評分、是否接受腦室-腹腔(ventriculo-peritoneal,V-P)分流手術(shù)、表皮生長因子受體-酪氨酸激酶抑制劑(epidermal growth factor receptortyrosine kinase inhibitor,EGFR-TKI)靶向治療、全身化療(systemic chemotherapy,SC)、全腦放療、腦膜轉(zhuǎn)移時的臨床癥狀和EGFR基因狀態(tài)與總生存顯著相關(guān)(P值均0.05)。多因素分析結(jié)果顯示,EGFR基因狀態(tài)、ECOG PS評分、SC和是否接受V-P分流手術(shù)是肺腺癌腦膜轉(zhuǎn)移患者的獨立預(yù)后因素(P值均0.05)。結(jié)論:肺腺癌腦膜轉(zhuǎn)移患者的總體預(yù)后較差,其中EGFR基因突變患者的預(yù)后相對較好;EGFR-TKI靶向治療、SC和V-P分流手術(shù)有助于延長肺腺癌腦膜轉(zhuǎn)移患者的生存期,改善其預(yù)后。
[Abstract]:Objective: to investigate the survival and prognostic factors of patients with meningeal metastasis from lung adenocarcinoma. Methods: the survival and prognostic factors of 65 patients with meningeal metastasis from lung adenocarcinoma were retrospectively analyzed. Results the median survival time of 65 patients was 7.4 months and the 1 year survival rate was 6. 2 / 65. The results of univariate analysis showed that gender, age, smoking history, meningeal metastasis time and brain metastasis had no significant correlation with total survival (P = 0.05). Whether or not to undergo ventricular / peritoneal ventriculo-peritoneal V-P shunt, epidermal growth factor receptortyrosine kinase inhibitor EGFR-TKI, systemic chemotherapy, whole brain radiotherapy, The clinical symptoms and EGFR gene status of meningeal metastasis were significantly correlated with total survival (P = 0.05). Multivariate analysis showed that EGFR gene status, ECOG PS score, SC and V-P shunt were independent prognostic factors in patients with meningeal metastasis of lung adenocarcinoma. Conclusion: the overall prognosis of patients with meningeal metastasis from lung adenocarcinoma is poor. The prognosis of patients with EGFR gene mutation is relatively good. Conclusion: EGFR-TKI targeted therapy of SC and V-P shunt surgery can prolong the survival time and improve the prognosis of patients with meningeal metastasis of lung adenocarcinoma.
【作者單位】： 鄭州大學(xué)人民醫(yī)院腫瘤內(nèi)科;鄭州大學(xué)人民醫(yī)院神經(jīng)外科;鄭州大學(xué)人民醫(yī)院放射科;鄭州大學(xué)人民醫(yī)院放療科;鄭州大學(xué)人民醫(yī)院胸外科;
【分類號】：R734.2

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