Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
Int J Surg. 2017 Aug;44:204-209. doi: 10.1016/j.ijsu.2017.05.033. Epub 2017 May 17.
Brain metastases are the most common malignant intracranial tumors, however, the prognosis of patients is still poor despite multiple treatment have been applicated. The aim of this study was to analyse parameters influence overall survival from patient, tumor and treatment. Summarized characteristics of long-time (>2 years) survivors furtherly.
In total, clinical data of 125patients between 2004 and 2015 were collected and the parameters from patients, tumor and treatment were evaluated. Univariate analysis was performed using Kaplan-Meier and Log-rank test, multivariate analysis was performed using Cox proportional hazards regression model, respectively.
Median overall survival time was 14.5 (95% confidence interval were 12.3-16.7) months and median survival time was 34.5 (95% confidence interval were 30.1-38.9) months in long-time survivors, respectively.KPS, RPA, GPA, number of brain metastases, extracranial metastases, treatment pattern and resection method were identified influence survival time significantly by univariate analysis. KPS, number of brain metastases, extracranial metastases and treatment pattern were independent prognosis factors by multivariate analysis. Long-time survivors obtain higher KPS, complete resection, adjuvant therapy postoperative more commonly.
Higher KPS, GPA I,RPA3.5∼4, single brain metastases, adjuvant therapy postoperative and complete resection were significant improve survival time, however, extracranial metastases significant decreased survival time. Patients who have good status and received multimodality therapy involved complete resection can survive longer time more commonly.
脑转移瘤是最常见的颅内恶性肿瘤，但尽管已经应用了多种治疗方法，患者的预后仍然较差。本研究旨在分析患者、肿瘤和治疗相关参数对总生存期的影响，并对生存时间较长（>2 年）的患者进行总结。
共收集了 2004 年至 2015 年间 125 例患者的临床资料，评估了患者、肿瘤和治疗相关参数。采用 Kaplan-Meier 和 Log-rank 检验进行单因素分析，采用 Cox 比例风险回归模型进行多因素分析。
中位总生存期为 14.5 个月（95%置信区间为 12.3-16.7），生存时间较长的患者中位生存期为 34.5 个月（95%置信区间为 30.1-38.9）。单因素分析显示，KPS、RPA、GPA、脑转移瘤数量、颅外转移、治疗方式和手术切除方式对生存时间有显著影响。多因素分析显示，KPS、脑转移瘤数量、颅外转移和治疗方式是独立的预后因素。生存时间较长的患者 KPS 较高，完全切除术后辅助治疗更为常见。
较高的 KPS、GPA I、RPA3.5∼4、单发脑转移、术后辅助治疗和完全切除可显著延长生存时间，而颅外转移则显著缩短生存时间。状态良好且接受包括完全切除在内的多模态治疗的患者通常能存活更长时间。
