| Objective: Through case review research, sum up the clinical and pathologicalfeatures of brain metastasis in our hospital in recent9years,discussion on regularityof brain metastases of malignant tumors and various related factors affecting theprognosis,provides the theory reference for the instruction clinical individuationtreatment and determination prognosis.Method: Collection patients that are histopathologically diagnosed as malignanttumor by CT or MRI or histopathology confirmed metastatic brain in GeneralHospital of Ningxia Medical University from Jan.2002to Jan.2011as researchobjective.They were followed up by telephone or visit, summarizes the status ofclinical and pathological characteristics and treatment of the region of brain metastasis,analysis of gender, age, ethnicity, body condition (KPS score) of patients, pathologictype, time, number, parts of the brain metastases, with or without associated withextracranial metastasis and nervous system symptoms，different treatment methodsand other factors influence on prognosis. Survival time was recorded from BMdiagnosed to die or final follow-up.Survival rate was calculated by Kaplan-Meiermethod.Log-rank method was adopted to compare the difference of each inferiorgroup in survival rate. The multivariate analysis about survival was performed withCox’s regression proportional model. Statistical significance was defined as P <0.05.Result:（1）The total incidence of brain metastases in our hospital with recentnine years was1.21%, primary lung cancer is the most, followed by breast cancer,gastrointestinal cancer, etc; Adenocarcinoma was the most common pathological type,next for scale cancer and cellule cancer; The age of onset to40-70years of age;BM occurs after the primary lesion diagnosis or treatment(for short after brainmetastases),and often with multiple metastases;The most common site of metastasis tothe brain, the cerebellum is little implicated, Rarely involving the meninges;Whenbrain metastases associated with nervous system symptoms.(2)For all patients,median survival time from BM diagnosed was10months,1-year and2-year survivalrates were29.4%and11.8%respectively.(3)The univariate analysis showed thatpathological type of primary tumor, the time of occurrence of BM, with or withoutsymptoms of nervous system and extracranial metastases and whether to adopt acomprehensive treatment are the factors that affect the survival of patients with BM（Pvalue for0.001、0.002、0.000、0.025and0.000）。Using multiple causes Cox regressionto analyze these factors, which shows that the time of occurrence of BM, with orwithout symptoms of nervous system and extracranial metastases and Whether toadopt a comprehensive treatment（especially with molecular targeted therapy）have asignificant influence on the survival time of BM(P value for0.000、0.017、0.023and0.000), are the independent prognostic factors of BM,the symptoms of nervous system,no extracranial metastasis, after brain metastases and the comprehensive treatment ofthe patients with longer survival.(4) Age,gender, ethnicity, body condition (KPS score)of patients, number, parts, RPA of BM and prognosis of brain metastases in patientswith no correlation (P value for0.805、0.749、0.382、0.093、0.817、0.541and0.232).Conclusions:1.The total incidence of brain metastases in our hospital withrecent nine years is low, primary lung cancer is the most,adenocarcinoma was themost common pathological type,focus on olders;Parts of BM in the brain usually andoften with multiple metastases.2.The survival time of patients With the symptoms ofnervous system, no extracranial metastasis and after brain metastases is long,aspotential therapeutic benefit people.3.Adopt a comprehensive treatment(especiallywith molecular targeted therapy) after the diagnosis of BM can improve the prognosis of patients, prolong the survival. |
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