The Efficacy of Surgical Treatment for Non-small Cell Lung Cancer with Single Brain Metastasis_West China Medical Journal

Authors：

JIA Kegang , CONG Wei , XUE Yang , WANG Xuehai , LIU Shengzhong

Department of Cardiothoracic Surgery, Sichuan Academy of Medical Sciences & Sichuan People’s Hospital, Chengdu, Sichuan 610072, P. R. China;

Corresponding author：

Keywords：

非小细胞肺癌; 脑转移; 手术治疗; 疗效

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目的　探讨非小细胞肺癌合并孤立性脑转移灶的手术治疗效果，分析影响患者生存期的因素。方法　回顾性分析2005年1月－2011年5月46例接受手术治疗的非小细胞肺癌合并孤立性脑转移灶患者的临床资料，其中男35例，女11例；年龄35～67岁，平均53.2岁；所有患者均行肺部原发肿瘤及脑部转移肿瘤切除术，其中肺叶切除术42例，全肺切除术4例，术后全部患者行全脑放射治疗，部分患者行系统化学疗法3～6周期。对随访患者的生存时间采用对数秩检验，分析影响生存率的因素。结果　术后病理检查提示腺癌27例，鳞癌15例，大细胞癌2例，其他类型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个月，平均生存期（27.8 ± 4.5）个月（乘积极限法）。对数秩检验结果提示N0与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长（P=0.002）。结论　外科手术治疗非小细胞肺癌合并孤立性脑转移灶的患者可以取得良好的治疗效果，腺癌患者及无纵隔淋巴结转移的患者生存期长。

Citation： JIA Kegang,CONG Wei,XUE Yang,WANG Xuehai,LIU Shengzhong. The Efficacy of Surgical Treatment for Non-small Cell Lung Cancer with Single Brain Metastasis. West China Medical Journal, 2012, 27(11): 1634-1637. doi: Copy

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11.	贾云龙, 郭胜, 景建超, 等. 肺癌脑转移的综合治疗的临床分析[J]. 齐齐哈尔医学院学报, 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.
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1. 　贺铭言, 尤庆山, 常金. 89例肺癌脑转移病例放疗疗效分析[J]. 实用肿瘤学杂志, 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. 　周兴芹, 季斌. 肺癌脑转移的治疗进展[J]. 中国肺癌杂志, 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. 　贾云龙, 郭胜, 景建超, 等. 肺癌脑转移的综合治疗的临床分析[J]. 齐齐哈尔医学院学报, 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.

West China Medical Journal

The Efficacy of Surgical Treatment for Non-small Cell Lung Cancer with Single Brain Metastasis

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