Szczepek B, Rowińska-Zakrzewska E
III Kliniki Gruźlicy i Chorób Płuc Instytutu Gruźlicy i Chorób Płluc w Warszawie.
Pneumonol Alergol Pol. 1996;64(1-2):40-4.
Brain metastases are one of the important causes of failure in the treatment of SCLC patients. Intracranial metastases are reported in 10% of the newly diagnosed SCLC pts. Further 20% brain metastases develop during therapy. Autopsy studies showed that 40%-60% of pts had evidence of intracranial spread at the time of death. The frequency of brain metastases increases with the duration of survival, reaching a probability of 80% after 2 years of observation. The high risk of brain metastases which developed in spite of chemotherapy was the reason of introducing PCI to the treatment. PCI reduces the risk of brain metastases to less than 10%, but unfortunately, does not prolong median survival. Probably this is due to the fact, that in the majority of cases the brain is one of many sites of metastases at the time of progression. In addition, in some pts brain metastases developed in spite of PCI and/or brain toxicity may develop after this treatment. Thus, up till now the role of PCI in the treatment of SCLC pts remains controversial. The indication for this treatment could improve if we have more exact information which pts have the greatest probability do develop metastases restricted to the brain only. This question was the main aim of our study.
脑转移是小细胞肺癌（SCLC）患者治疗失败的重要原因之一。据报道，10%新诊断的SCLC患者存在颅内转移。另外，20%的脑转移在治疗期间发生。尸检研究表明，40%-60%的患者在死亡时有颅内转移的证据。脑转移的发生率随生存时间的延长而增加，观察2年后发生脑转移的概率达到80%。尽管进行了化疗，但脑转移的高风险是在治疗中引入全脑预防性照射（PCI）的原因。PCI可将脑转移的风险降低至10%以下，但遗憾的是，并未延长中位生存期。这可能是由于在大多数情况下，进展时脑是多个转移部位之一。此外，在一些患者中，尽管进行了PCI仍发生脑转移，且/或在该治疗后可能发生脑毒性。因此，迄今为止，PCI在SCLC患者治疗中的作用仍存在争议。如果我们能获得更准确的信息，即哪些患者发生仅局限于脑转移的可能性最大，那么该治疗的适应证可能会得到改善。这个问题是我们研究的主要目的。
