Yoshinaga Y, Enatsu S, Iwasaki A, Shirakusa T
Department of Thoracic Surgery, St. Mary's Hospital, Kerume, Japan.
Kyobu Geka. 2006 Jan;59(1):41-5.
The brain is one of the most common sites of metastasis from lung cancer. The strategies of treatment for non-small cell lung cancer patient with synchronous brain metastases (stage IV) is controversial. We evaluate retrospectively the effectiveness of surgical treatment for these patients. Forty patients were divided into 3 groups on the basis of surgical treatment, group A of patients received both lung and brain resection, group B of patients received lung resection plus gamma knife therapy, group C of patients received brain resection. Median survival from the date of diagnosis of brain metastasis was as follows: group A 331 days, group B 151 days and group C 92 days. Univariate analysis revealed that adenocarcinoma histology and serum LDH significantly affected survival. Multivariate analysis found that only adeocarcinoma histology also affected the survival. It is concluded that surgical treatment may acceptable in selected group of non-small cell lung cancer patients with synchronous brain metastases.
脑是肺癌最常见的转移部位之一。对于伴有同步脑转移（IV期）的非小细胞肺癌患者的治疗策略存在争议。我们回顾性评估了这些患者手术治疗的有效性。40例患者根据手术治疗情况分为3组，A组患者接受肺部和脑部切除，B组患者接受肺部切除加伽玛刀治疗，C组患者接受脑部切除。自脑转移诊断之日起的中位生存期如下：A组331天，B组151天，C组92天。单因素分析显示腺癌组织学类型和血清乳酸脱氢酶显著影响生存期。多因素分析发现只有腺癌组织学类型也影响生存期。结论是手术治疗对于部分伴有同步脑转移的非小细胞肺癌患者可能是可接受的。
