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1、萬方數(shù)據(jù)廣西醫(yī)科大學(xué)2015屆碩士學(xué)位論文晚期非小細(xì)胞肺癌腦轉(zhuǎn)移高危因素分析案≤2線是NSCLC發(fā)生腦轉(zhuǎn)移的危險(xiǎn)因素,而年齡、性別、ECOG評分、EGFR突變狀態(tài)、LDH水平不是腦轉(zhuǎn)移高危因素。4.Logistic回歸多因素分析顯示,吸煙史(OR2.452;95%CI:1.138—5.169;P:-0.022)、腺癌(OR2.389;95%CI:1.029—5.547;P=0.043)、血清CEA>15ng/ml(OR2.422;95%CI:1.181—4.965;P:-0.016)和化療方案≤2線OR3.140;95%CI:1.477—6.676P=0
2、.003)為晚期NSCLC腦轉(zhuǎn)移的獨(dú)立的危險(xiǎn)因素。5.不同治療方法對62例腦轉(zhuǎn)移患者預(yù)后有影響(P<0.05),單純治療組與綜合治療組的中位生存期分別為3個(gè)月、14個(gè)月;顱腦放療組與無顱腦放療組中位生存期分別為14個(gè)月、6個(gè)月。;靶向治療組與非靶向治療組的中位生存期分別為17個(gè)月、6個(gè)月。在靶向治療組中,6例EGFR突變型的患者中位生存期為17個(gè)月明顯長于1例EGFR野生型的患者3個(gè)月。結(jié)論晚期NSCLC腦轉(zhuǎn)移高危因素為吸煙史、腺癌、血清CEA>15ng/ml、化療方案42線;不同治療方法對NSCLC腦轉(zhuǎn)移預(yù)后有影響,多學(xué)科綜合治療為腦轉(zhuǎn)移患者最佳治療方
3、式,同時(shí)要根據(jù)患者具體情況采取個(gè)體化治療策略。關(guān)鍵詞非小細(xì)胞肺癌,腦轉(zhuǎn)移,血清CEA,危險(xiǎn)因素萬方數(shù)據(jù)廣西醫(yī)科大學(xué)2015屆碩士學(xué)位論文晚期非小細(xì)胞肺癌腦轉(zhuǎn)移高危因素分析RiskFactorsforBrainMetastasesinAdvancedNon--SmallCellLungCancerAbstractObjective:Brainmetastasishasbecomeoneofthemostimportantfactorsofthefailuretreatmentofadvancednon—smallcelllungcancer(NSCLC).
4、Weintendedtoidentifyriskfactorsthataffectbrainmetastases(BM)inpatientswithNSCLC,whichmayguidethechoiceofpatientsofhighriskbrainmetastasesinclinical.Methods:Theclinicaldataof158advancedNSCLCpatientshospitalizedfromApril2008toJune2013wereextractedandthenretrospectivelyanalyzed(nobr
5、ainmetastasis96,brainmetastasis62).AlltheenrolledpatientshadnewlydiagnosedNSCLCwithstageIVandnotreceivedtreatmentpreviously.Wetriedtoidentifyage,gender,smoking,ECOGscore,pathologicaltype,EGFRmutationstatus,serumCEAlevel,LDHlevelsassociatedwithadvancedNSCLCbrainmetastases.Thenthe6
6、2casesoftreatmentofpatientswithbrainmetastaseswereanalyzed.Results:1.Theincidenceofbrainmetastasiswas39.2%(62/158),atthetimeofinitialdiagnosisofNSCLC13.9%(22/158),the1-yearand2-yearbrainmetastasisrateswere30.3%(48/158)and37.9%(60/158),respectively.Themediansurvivalforallpatientsw
7、as14.8months,the1-yearand2-yearsurvivalratewere62%and26%.Themediansurvivalofbrainmetastasispatientswas12.3months,the1-yearand2-yearsurvivalratewas52%and22%.Themediansurvivalofnobrainmetastasispatients4萬方數(shù)據(jù)廣西醫(yī)科大學(xué)2015屆碩士學(xué)位論文晚期非小細(xì)胞肺癌腦轉(zhuǎn)移高危因素分析was16.4months,the1-yearand2-yearsurvivalr
8、atewas68%and28%.2.TheareaundertheROCcurv