Kutuki S, Ito H, Shigematsu N, Toya K, Ka W J, Tsukamoto N, Kumagaya H, Uematsu M, Kubo A
Department of Radiology, Keio University, School of Medicine, Tokyo, Japan.
Nihon Igaku Hoshasen Gakkai Zasshi. 1996 May;56(6):426-31.
One hundred ten patients with brain metastases (76 lung cancer, 11 breast cancer, 7 colorectal cancer and others) were treated with radiotherapy, and the results were retrospectively evaluated. Neurologic symptoms were improved in 66% of patients. The relationship between improvement of neurologic symptoms and several factors, including irradiation dose, primary lesion, histology, term between first treatment and recurrence, clinical symptoms and CT findings, was analyzed. There was no significant correlation between symptom relief and these factors except for the number of metastatic lesions. Four of 110 patients could survive more than 2 years after radiotherapy: one with lung cancer, one with breast cancer, one with rectum cancer and one with uterine cancer. The factors that were analyzed for symptom relief were also studied to determine their effect on the survival of lung cancer patients with brain metastases. The patients who had higher dose irradiation (50 Gy) of improvement of neurological symptoms after radiotherapy survived significantly longer than those who had 30 Gy of irradiation or no symptom relief. Multivariate analysis of these factors showed that improvement of symptoms and irradiation dose were similarly important prognostic factors, whereas the others were not correlated with survival.
110例脑转移瘤患者（76例肺癌、11例乳腺癌、7例结直肠癌及其他）接受了放射治疗，并对结果进行回顾性评估。66%的患者神经症状得到改善。分析了神经症状改善与包括照射剂量、原发灶、组织学类型、首次治疗与复发间隔时间、临床症状及CT表现等多种因素之间的关系。除转移灶数量外，症状缓解与这些因素之间均无显著相关性。110例患者中有4例放疗后存活超过2年：1例肺癌、1例乳腺癌、1例直肠癌和1例子宫癌。还研究了分析症状缓解的因素对脑转移肺癌患者生存的影响。放疗后神经症状改善且接受较高剂量照射（50 Gy）的患者比接受30 Gy照射或症状未缓解的患者存活时间显著更长。对这些因素进行多因素分析表明，症状改善和照射剂量是同样重要的预后因素，而其他因素与生存无相关性。
