摘要
目的探讨伽玛刀治疗肺癌脑转移瘤近期疗效的影响因素。方法回顾性分析采用伽玛刀治疗肺癌脑转移瘤患者的临床资料,将年龄、性别、肺癌病理类型、转移瘤部位、转移瘤大小、转移瘤数目、是否颅外转移、治疗前KPS评分、治疗前PRA评分、原发灶与脑转移瘤诊断时间间隔等列为影响因素,通过术后3个月时WHO实体瘤评价标准评定术后近期疗效,采用卡方检验和非条件Logistic回归多因素分析探讨影响因素与近期疗效的关系。结果术后3个月时脑转移瘤完全缓解35例,部分缓解17例,无变化29例,进展16例。Pearson卡方检验显示原发肿瘤病理类型、转移瘤部位、治疗前KPS评分、治疗前PRA评分、原发灶与脑转移瘤诊断时间间隔等因素对疗效有显著性影响,非条件Logistic回归多因素分析显示病理类型、转移瘤部位、治疗前KPS评分、治疗前PRA评分是影响近期疗效的独立危险因素。结论有效的局部放射剂量是伽玛刀治疗脑转移瘤近期疗效的重要保证,高侵袭性不利于伽玛刀对肿瘤的局部控制。
Objective It is to approach the influence factors on early therapeutic effect of Gamma Knife surgery for patients with brain metastases of pulmonary cancer. Methods The clinical characteristics of patients with brain metastases of pulmonary cancer undergoing Gamma Knife surgery were analyzed retrospectively. Age,gender,pathological type,position,size,quan-tity,extracranial metastases,KPS and PRA score before radiosurgery,and interval of diagnosis between primary lesion and brain metastases were analyzed as influencing factors. Therapeutic effect at 3 months after radiosurgery was evaluated by WHO solid tumor evaluation criteria,and then,chi - square test and non-condition Logistic regression analysis were employed to de-fine the relationship between the early therapeutic effect and factors. Results At 3 months after surgery,there were 35,17,29 and 16 cases with complete remission,partial remission,no change and progression respectively. Pathological type,position, KPS and PRA score before radiosurgery,interval of diagnosis between primary lesion and brain metastases were revealed as the factors significantly related to therapeutic effect by Pearson chi-square test. Then,pathological type,position,KPS and PRA score before radiosurgery were shown as independent predictors by the non-condition Logistic regression analysis. Conclusion Effective radiological dose play a predominant role influencing early therapeutic effects for Gamma Knife surgery treating brain metastases. High invasion is harmful to local controlling of neoplasm treated with Gamma Knife surgery.
出处
《现代中西医结合杂志》
CAS
2014年第27期2971-2973,2985,共4页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
全军医学科技青年培育项目(13QNP081)
关键词
脑转移瘤
伽玛刀
随访
预后
影响因素
brain metastases
Gamma Knife surgery
follow-up
prognosis
influence factors
