Clinical Analysis Of Two Different Radiotherapy Methods For Multiple Brain Metastases Of Non-small Cell Lung Cancer

Objective: To compare the efficacy of whole brain radiotherapy combined with or without local stereotactic radiotherapy in patients with multiple brain metastases from non-small cell lung cancer,and analyze related prognostic factors.Methods: 49 patients with multiple brain metastases from non-small cell lung cancer(NSCLC)treated in the Department of Oncology,second affiliated Hospital of Hunan normal University from April 2012 to April2014 were collected and divided into study group(n=25)and control group(n=24).The study group was treated with whole brain radiotherapy combined with local stereotactic radiotherapy,and the control group was treated with whole brain radiotherapy.After treatment,follow-up treatments such as chemotherapy,targeted therapy and re-course radiotherapy were performed according to the condition of the patients.There was no significant difference in general data and follow-up treatment between the study group and the control group.The short-term effective rate,safety,quality of life,cause of death and survival time of the two groups were compared,and the related factors affecting prognosis were analyzed.Results: Three months after radiotherapy,the objective remissionrate and disease control rate of the study group were significantly higher than those of the control group,which were 92.3% VS 58.33% and 96.0%VS 70.83%,respectively.The degree of early and late adverse reactions related to radiation brain injury in the two groups were limited to grade1-2,and there was no significant difference in the incidence of adverse reactions between the two groups.At the end of radiotherapy,the improvement rate of quality of life in the study group was 80%,which was significantly higher than that in the control group(45.83%).34.78%and 52.17% of the patients in the study group and the control group died of intracranial progression respectively,and 65.21% and 47.83% of the patients died of extracranial diseases.There was no significant difference in the causes of death between the two groups.The median overall survival time and intracranial progression-free survival time in the study group were significantly higher than those in the control group,21 months VS 9 months and 11 months VS 6 months,respectively.Multivariate prognostic analysis of intracranial progression-free survival showed that different methods of radiotherapy and chemotherapy were independent factors affecting the prognosis of patients.Multivariate prognostic analysis of overall survival showed that the control of pulmonary lesions,different modes of radiotherapy,chemotherapy and re-course radiotherapy were independent factors affecting the prognosis of patients.Conclusion: The effect of whole brain radiotherapy combined with local stereotactic radiotherapy for multiple brain metastases of non-small cell lung cancer is better than that of whole brain radiotherapy alone,and can improve the prognosis of patients.