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目的:评估非小细胞肺癌合并单发脑转移患者接受外科治疗的有效性。方法:分析行脑部和胸部病灶联合切除的非小细胞肺癌单发脑转移患者的临床及随访资料。结果:21例患者进行了单发脑转移病灶切除和后续的肺癌根治术,18例(86%)患者有纵隔淋巴结转移,其中N1淋巴结阳性8例,N2淋巴结阳性10例。中位生存期32个月(95%置信区间15～49个月),1、2和5年生存率分别为70%、43%、22%。对可能影响预后的指标进行单因素分析,提示淋巴结转移是影响预后的危险因素(P=0.002)。结论:对于非小细胞肺癌单发脑转移的患者,在保证病灶完全切除和手术耐受性的前提下,宜对胸部和脑部病灶同时采取积极的外科治疗策略,以获得最佳疗效。
PURPOSE: To evaluate the effectiveness of surgical treatment in patients with non-small cell lung cancer and single brain metastases. Methods: The clinical and follow-up data of patients with solitary brain metastasis of non-small cell lung cancer undergoing combined resection of brain and chest lesions were analyzed. RESULTS: Twenty-one patients underwent single-head brain tumor resection and radical resection of lung cancer. 18 patients (86%) had mediastinal lymph node metastases, of which N1 was positive in 8 and N2 was positive in 10. The median survival was 32 months (95% confidence interval 15-49 months), and the 1, 2, and 5-year survival rates were 70%, 43%, and 22%, respectively. Univariate analysis of the possible prognostic indicators suggested that lymph node metastasis was a risk factor for prognosis (P = 0.002). Conclusion: For patients with solitary brain metastasis of non-small cell lung cancer, under the premise of complete resection and surgical tolerance, it is appropriate to adopt a positive surgical treatment strategy for both the chest and brain lesions in order to obtain the best therapeutic effect.