非小細胞肺癌合并孤立腦轉移灶的手術療效觀察_《華西醫學》

作者：

賈克剛 , 叢偉 , 薛洋 , 王雪海 , 劉勝中

四川省醫學科學院·四川省人民醫院胸心外科（成都，610072）;

關鍵詞：

非小細胞肺癌腦轉移手術治療療效

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目的　探討非小細胞肺癌合并孤立性腦轉移灶的手術治療效果，分析影響患者生存期的因素。方法　回顧性分析2005年1月－2011年5月46例接受手術治療的非小細胞肺癌合并孤立性腦轉移灶患者的臨床資料，其中男35例，女11例；年齡35～67歲，平均53.2歲；所有患者均行肺部原發腫瘤及腦部轉移腫瘤切除術，其中肺葉切除術42例，全肺切除術4例，術后全部患者行全腦放射治療，部分患者行系統化學療法3～6周期。對隨訪患者的生存時間采用對數秩檢驗，分析影響生存率的因素。結果　術后病理檢查提示腺癌27例，鱗癌15例，大細胞癌2例，其他類型2例。患者1年生存率80%，2年生存率41%，3年生存率14%，中位生存期23個月，平均生存期（27.8 ± 4.5）個月（乘積極限法）。對數秩檢驗結果提示N0與N1患者比N2患者生存率高（P=0.024），腺癌患者生存期比非腺癌患者生存期長（P=0.002）。結論　外科手術治療非小細胞肺癌合并孤立性腦轉移灶的患者可以取得良好的治療效果，腺癌患者及無縱隔淋巴結轉移的患者生存期長。

引用本文： 賈克剛,叢偉,薛洋,王雪海,劉勝中. 非小細胞肺癌合并孤立腦轉移灶的手術療效觀察. 華西醫學, 2012, 27(11): 1634-1637. doi: 復制

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6.	Girard N, Cottin V, Tronc F, et al. Chemotherapy is the cornerstone of the combined surgical treatment of lung cancer with synchronous brain metastases[J]. Lung Cancer, 2006, 53(12): 51-58.
7.	Wron′ski M, Arbit E, Burt M, et al. Survival after surgical treatment of brain metastases from lung cancer: a follow-up study of 231 patients treated between 1976 and 1991[J]. J Neurosurg, 1995, 83(4): 605-616.
8.	IH, Lee JI, Nam DH, et al. Surgical treatment of non–small cell lung cancer wit h isolated synchronous brain metastases[J]. J Korean Med Sci, 2006, 21 (2): 236-241.
9.	Bonnette P, Puyo P, Gabriel C, et al. Surgical management of non-small cell lung cancer with synchronous brain metastases[J]. Chest, 2001, 119(10): 1469-1475.
10.	Iwasaki A, Shirakusa T, Yoshinaga Y, et al. Evaluation of the treatment of non-small cell lung cancer with brain metastasis and the role of risk score as a survival predictor[J]. Eur J Cardiothorac Surg, 2004, 26(11): 488-493.
11.	賈云龍, 郭勝, 景建超, 等. 肺癌腦轉移的綜合治療的臨床分析[J]. 齊齊哈爾醫學院學報, 2009, 30(12): 1436-1437.
12.	Auchter RM, Lamond J P, Alexander E, et al. A multiinstitutional outcome and prognostic factor analysis of radiosurgery for resectable single brain metastasis[J]. Int1 Radiat Oncol Biol Phys, 1996, 35(8): 27.
13.	Burt M, Wronski M, Arbit E, et al. Resection of brain metastases from non-small cell lung carcinoma. Results of therapy[J]. J Thorac Cardiovasc Surg, 1992, 103(6): 399-411.

1. 　賀銘言, 尤慶山, 常金. 89例肺癌腦轉移病例放療療效分析[J]. 實用腫瘤學雜志, 2007, 21(3): 238-243.
2. 　Ebert BL, Niemierko E, Shafer K, et al. Use of temozolomide with other cytotoxie chemotherapy in the treatment of patients with recurrent brain metestases from lung cancer[J]. Oncologist, 2003, 8(1): 69-75.
3. 　Pierluigi G, Stefano M, Antonio D, et al. Non-small cell lung cancer with single brain metastasis: the role of surgical treatment[J]. Eur J Cardiothorac Surg, 2001, 9(20): 361-366.
4. 　周興芹, 季斌. 肺癌腦轉移的治療進展[J]. 中國肺癌雜志, 2009, 12(10): 1119-1122.
5. 　Yun Oh, Taylor S, Bekele BN, et al. Number of metastatic sites is a strong predictor of survival in patients with non-small cell lung cancer with or without brain metastases[J]. Cancer, 2009, 115(13): 2930-2938.
6. 　Girard N, Cottin V, Tronc F, et al. Chemotherapy is the cornerstone of the combined surgical treatment of lung cancer with synchronous brain metastases[J]. Lung Cancer, 2006, 53(12): 51-58.
7. 　Wron′ski M, Arbit E, Burt M, et al. Survival after surgical treatment of brain metastases from lung cancer: a follow-up study of 231 patients treated between 1976 and 1991[J]. J Neurosurg, 1995, 83(4): 605-616.
8. 　IH, Lee JI, Nam DH, et al. Surgical treatment of non–small cell lung cancer wit h isolated synchronous brain metastases[J]. J Korean Med Sci, 2006, 21 (2): 236-241.
9. 　Bonnette P, Puyo P, Gabriel C, et al. Surgical management of non-small cell lung cancer with synchronous brain metastases[J]. Chest, 2001, 119(10): 1469-1475.
10. 　Iwasaki A, Shirakusa T, Yoshinaga Y, et al. Evaluation of the treatment of non-small cell lung cancer with brain metastasis and the role of risk score as a survival predictor[J]. Eur J Cardiothorac Surg, 2004, 26(11): 488-493.
11. 　賈云龍, 郭勝, 景建超, 等. 肺癌腦轉移的綜合治療的臨床分析[J]. 齊齊哈爾醫學院學報, 2009, 30(12): 1436-1437.
12. 　Auchter RM, Lamond J P, Alexander E, et al. A multiinstitutional outcome and prognostic factor analysis of radiosurgery for resectable single brain metastasis[J]. Int1 Radiat Oncol Biol Phys, 1996, 35(8): 27.
13. 　Burt M, Wronski M, Arbit E, et al. Resection of brain metastases from non-small cell lung carcinoma. Results of therapy[J]. J Thorac Cardiovasc Surg, 1992, 103(6): 399-411.

《華西醫學》

非小細胞肺癌合并孤立腦轉移灶的手術療效觀察

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《華西醫學》

非小細胞肺癌合并孤立腦轉移灶的手術療效觀察

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