摘要
目的评估全脑放疗(WBRT)在非小细胞肺癌脑膜转移(NSCLC-LM)的作用。方法回顾分析2014—2019年间在广东三九脑科医院收治的80例经细胞学和/或影像学证实为NSCLC-LM患者临床资料。EGFR突变阳性者49例,野生型者31例。WBRT者38例,非WBRT者42例。Kaplan-Meier法生存分析,Cox模型预后因素分析。结果全组患者中位总生存(mOS)为8.0个月(4.4~11.6个月),1年OS率为39%。EGFR突变阳性者比野生型者的mOS长(12.6个月∶4.1个月,P<0.001);年龄<53.5岁比≥53.5岁者的mOS更长(12.6个月∶6.1个月,P=0.041)。WBRT与非WBRT对EGFR突变阳性者的mOS无差异(12.6个月∶25.9个月,P=0.490),对野生型者的mOS延长(8.0个月∶2.1个月,P=0.002)。多因素分析显示年龄较小(P=0.048)、WBRT(P=0.025)是EGFR野生型NSCLC-LM患者有利的预后因素。结论WBRT给EGFR野生型NSCLC-LM患者带来生存获益,因此推荐可对NSCLC-LM患者进行分子生物学分层基础上的WBRT。
Objective To evaluate the role of whole-brain radiation therapy(WBRT)in meningeal metastasis(LM)in non-small-cell lung cancer(NSCLC).Methods From December 2014 to March 2019,eighty NSCLC patients with cytologically and/or radiologically proven LM diagnosis were retrospectively analyzed.49 patients had positive for EGFR mutations,and 31 patients were in wild-type patients.38 patients were used to WBRT,with 42 non-WBRT.The survival analysis was played by Kaplan-Meier method.Prognostic factors analysis was played by Cox model.Results All patients median overall survival(mOS)was 8.0(95%CI:4.4-11.6)months,and the one-year OS was 39%.The mOS for EGFR-mutated LM patients was 12.6 months versus only 4.1 months for patients with wild-type EGFR(P<0.001).Younger patients(<53.5 yrs.)appeared to have a better OS than older patients(≥53.5 yrs.)(12.6 months vs.6.1 months,P=0.041).No survival benefits were found in EGFR-mutated patients who received WBRT(12.6 months vs.25.9 months,P=0.490).In contrast,mOS was significantly prolonged in wild-type EGFR patients with WBRT versus non-WBRT(mOS:8.0 months vs.2.1 months,P=0.002).Multivariate analysis indicated that WBRT(P=0.025)and younger age(P=0.048)were independent prognostic factors that predicted prolonged survival for wild-type EGFR LM patients from NSCLC.Conclusion WBRT has clear survival advantages for patients with wild-type EGFR,and molecular biological stratification of LM patients for WBRT may be highly recommended.
作者
甄俊杰
李少群
赖名耀
山常国
周江芬
洪伟平
杨艳莹
艾茹玉
王辉
叶敏婷
蔡林波
Zhen Junjie;Li Shaoqun;Lai Mingyao;Shan Changguo;Zhou Jiangfen;Hong Weiping;Yang Yanying;Ai Ruyu;Wang Hui;Ye Minting;Cai Linbo(Department of Oncology,Guangdong Sanjiu Brain Hospital,Guangzhou 510510,China)
出处
《中华转移性肿瘤杂志》
2021年第4期292-297,共6页
Chinese Journal of Metastatic Cancer
关键词
肺癌
脑膜转移/全脑放射疗法
肺癌
脑膜转移/外科学
肺癌
脑膜转移/化学疗法
中位总生存
Lung cancer,meningeal metastasis/whole brain radiation therapy
Lung cancer,meningeal metastasis/surgery
Lung cancer,meningeal metastasis/chemotherapy
Median overall survival
作者简介
通信作者:蔡林波,Email:13503030491@163.com
