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| 老年小细胞肺癌患者预防性全脑放疗的研究探讨 |
| Research and Discussion on Prophylactic Whole-Brain Radiotherapy for Elderly Patients with Small Cell Lung Cancer |
| 投稿时间：2024-12-22 修订日期：2025-05-15 |
| DOI： |
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| 中文关键词: 小细胞肺癌 预防性全脑放疗 老年患者 海马保护 |
| 英文关键词:Small cell lung cancer prophylactic whole brain radiotherapy elderly patients hippocampal protection |
| 基金项目:广西壮族自治区卫生和计划生育委员会自筹经费科研课题（Z-B20231444） |
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| 中文摘要: |
| 【】目的? 研究化疗后达完全缓解(complete response, CR)、部分缓解(partial remission,PR)的老年小细胞肺癌 (small cell lung cancer,SCLC)患者行预防性脑照射(prophylactic cranial irradiation, PCI) 的最佳获益人群。 方法 收集2018-2022年间在广西医科大学第四附属医院接受4周期标准化疗后,治疗疗效达到CR/PR 且年龄在60-75岁的83例小细胞肺癌患者的基本资料,根据是否行PCI治疗分为两组,非PCI组39人,PCI组44人,通过分析两组无脑转移生存期(brain metastasis-free survival, BMFS)、总生存期( overall survival,OS)、简易精神状态量表( Mini-Mental Statement Examination,MMSE)评分,回顾性分析年轻老年组小细胞肺癌患者PCI获益因素。使用 log-rank 法进行单因素分析,使用 COX 回归法进行多因素分析,使用 Kaplan–Meier 法绘制生存曲线,使用t 检验进行组间比较。结果 单因素分析显示PCI、性别等因素与生存相关,PCI、分期、初始肿瘤大小与无脑转移生存期相关,多因素分析显示PCI为OS的独立影响因素。PCI改善患者的总生存期(P= 0.01),PCI提高患者的无脑转移生存期(P= 0.02)。HA-PCI保护患者神经认知功能(P= 0.27)。 结论? 年龄60～75岁的小细胞肺癌患者行PCI治疗可改善总生存期及无脑转移生存期,海马保护预防性全脑放疗可保护患者神经认知功能。 |
| 英文摘要: |
| Objective：To study the best beneficiaries of preventive brain irradiation (PCI) for elderly patients with small cell lung cancer (SCLC) who achieved complete response, CR) and partial remission (PR) after chemotherapy .
Methods：The basic data of 87patients with small cell lung cancer aged 60-75 years who received four cycles of standard chemotherapy in the Fourth Affiliated Hospital of Guangxi Medical University from 2018 to 2022 were collected. They were divided into two groups according to whether they were treated with PCI or not. By analyzing the brain metastasis-free survival, BMFS), overall survival (OS) and mini-mental state examination (MMSE) scores, and the benefit factors of PCI in young and elderly patients with small cell lung cancer were analyzed retrospectively. Log-rank method was used for univariate analysis, COX regression method was used for multivariate analysis, Kaplan-Meier method was used to draw the survival curve, and two independent samples were used for t-test.
Results：Univariate analysis showed that PCI and NSE level before treatment were related to survival, while multivariate analysis showed that PCI was an independent influencing factor of BMFS and OS. PCI improved the overall survival time of patients (P= 0.01), while PCI improved the survival time without brain metastasis (P= 0.02). HA-PCI protects patients' neurocognitive function (P= 0.27)
Conclusions：PCI can improve the overall survival time and survival time without brain metastasis in patients with small cell lung cancer aged 60 ~ 75 years, and preventive whole brain radiotherapy with hippocampus protection can protect patients' neurocognitive function. |
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