94例食管癌患者脑转移后生存时间的影响因素分析
Influencing Factors of Survival Time After Brain Metastasis in Ninety-Four Paitents of Esophageal Carcinoma
姚乐静 1张鹏 2单国平 2王怀宇 2封巍2
作者信息
- 1. 浙江中医药大学,浙江杭州 310053;浙江省肿瘤医院,浙江杭州 310022
- 2. 浙江省肿瘤医院,浙江杭州 310022
- 折叠
摘要
[目的]总结食管癌患者脑转移后生存时间的影响因素.[方法]回顾性分析了 2012年至2022年间在浙江省肿瘤医院诊疗的12 760例食管癌患者的临床资料.收集食管癌原发灶和脑转移灶的病理特征、原发灶和转移灶的治疗方式等临床资料.随访采用门诊复查或电话随访;脑转移后生存时间定义为脑转移确诊至死亡(或末次随访)时间区间.采用SPSS 23统计软件进行数据分析,采用Kaplan-Meier法分析食管癌脑转移患者的临床病理特征与脑转移后生存时间的关系,并采用Cox回归法进行多因素分析.[结果]12 760例食管癌患者中,脑转移发生94例(0.74％).食管癌确诊至脑转移确诊的间隔中位时间为0.69年.在食管癌脑转移94例中,随访期间死亡84例,脑转移后中位生存时间为0.61年,1年生存率为37.3％.单因素分析显示M分期、KPS评分、单发脑转移灶、颅外转移史、后续肝转移、原发灶治疗方式、原发灶免疫治疗、脑转移灶手术史、放疗史和化疗史是脑转移后生存时间的影响因素(P均＜0.05).Cox多因素分析显示M分期(OR=1.757,95％CI:1.033～2.989)、颅外转移(OR=1.741,95％CI:1.031～2.940)、KPS 评分(OR=0.977,95％CI:0.965～0.989)是影响食管癌脑转移患者预后的独立的影响因素.[结论]食管癌低M分期、脑转移确诊时高KPS评分、单发脑转移灶、无颅外转移史、无后续肝转移、原发灶和脑转移灶积极治疗的患者是获得较好的脑转移后生存期的影响因素.
Abstract
[Objective]To summarize the influencing factors of survival after brain metastasis in esophageal cancer patients.[Methods]The clinical data of 12 760 esophageal carcinoma patients ad-mitted at the Zhejiang Cancer Hospital from 2012 to 2022 were analyzed retrospectively.The relation-ship between clinicopathological features and survival time after brain metastasis in patients with esophageal cancer was analyzed with Kaplan-Meier method,and the influencing factors on survival of patients were analyzed with multivariate Cox regression model.[Results]Among 12 760 patients with esophageal carcinoma,94 cases(0.74％)had brain metastases.The median interval between diagnosis of esophageal cancer and diagnosis of brain metastases was 0.69 years.Of the 94 cases with brain metastasis,84 died during follow-up,the median survival time after brain metastasis was 0.61 years with a 1-year survival rate of 37.3％.Univariate analysis showed that M stage,KPS score,single brain metastasis,extracranial metastasis,liver metastasis,primary treatment method,primary immunothera-py,brain metastasis surgery,brain metastasis radiotherapy,and brain metastasis chemotherapy were significantly associated with survival time after brain metastasis(all P＜0.05).Multivariate analysis showed that M staging(OR=1.757,95％CI:1.033～2.989)and extracranial metastasis(OR=1.741,95％CI:1.031～2.940)were independent risk factors of brain metastasis in esophageal cancer patients,while KPS score was a protective factor(OR=0.977,95％CI:0.965～0.989).[Conclusion]Esophageal cancer patient with low M stage,high KPS score at diagnosis of brain metastasis and no history of extracranial metastasis may achieve better survival after brain metastasis.
关键词
食管肿瘤/脑转移/脑转移后生存时间/预后/影响因素Key words
esophageal neoplasms/brain metastasis/survival after brain metastasis/survival/influence factor引用本文复制引用
基金项目
浙江省医药卫生科技计划项目(2022498520)
出版年
2024
NETL
NSTL
万方数据