폐암으로 인한 뇌전이암 - 치료 및 예후에 대한 분석 -
Brain Metastasis from Lung Cancer - Treatment and Prognosis -
소속 상세정보
박봉진/Bong Jin Park
임영진/김태성/이봉암/임언/김국기/Young Jin Lim/Tae Sung Kim/Bong Arm Rhee/Uon Leem/Gook Ki Kim
KMID : 0359819980270010053
Abstract
서론
원발성 성종양에 대한 진단기기의 발달로 조기진단이 가능해지는 등 진단율이 향상되었
고, 수술수기, 방사선 치료 및 항암화학요법의 진보로 원발성 악성종양 환자의 생존기간이
연장됨에 따라 전이성 뇌종양의 발생과 진단되는 환자수가 증가되고 있으며, 발병 후 치료
결과가 호전됨에 따라 전체 환자의 수도 증가하고 있다
그러나 전이성 뇌종양의 치료결과는 수술수기의 발달과 방사선치료 및 방사선 수술, 항암
화학요법의 발달에도 불구하고 치료효과는 만족스럽지 못하며 특히, 가장 흔한 뇌전이암인
폐암에 의한 뇌전이암의 치료결과도 불량한 것으로 보고되고 있다 이에 임상양상에 따른 예
후 및 치료방법에 따른 뇌전이암의 예후를 평가함으로써 향후 치료방침을 설정하는데 지침
이 되고자 본 연구를 시행하였다
#초록#
The treatment of brain tumors metastasizing from lung cancer though the outcome
has been unsatisfactory. Through an examination of the prognosis in patients treated
with varying modalities, this study aims to determine which gives the best results.
We analyzed 110 of 124 cases, histologically diagnosed between 1985 and 1994, in
which lung cancer had metastasized to the brain. Radiotherapy, chemotherapy and
conservative management had been implemented. The patients' mean age was 58(range
23 to 76) years ; the M:F ratio was 74 : 36. The histological diagnosis was squamous
cell carcinoma in 25 cases, adenocarcinoma in 50, small cell carcinoma in 24, and large
cell carcinoma in 11. The median metastatic period between the lung cancer and
metastatic tumor was 11.5 months ; the longest duration was 42 months(one cases). In
63 cases primary lung cancer and brain metastasis were diagnosed simultaneously. Of
the total cases, 47 involved solitary metastasis and 63, multiple. The chief complaints
were headache in 38 cases, hemiparesis in 48, cognitive function defect in 16, and
seizure in eight. Metastasis to other organs at the time of diagnosis was as follow :
adrenal gland, 6 ; bone, 9 ; liver, 4 ; lung, 3 ; leptomeninges, 1.
Four patients had undergone craniotomy, Two only chemotherapy ; and 41.
radiotherapy. Seven patients underwent gamma knife radiosurgery ; 43 were treated with
a single modality ; and 53, by combined therapy. The median survival period in cases of
surgery alone, radiotherapy, chemotherapy and gamma knife radiosurgery was 17
months, 5.7 months, 3.5 month and 8.0 months, respectively. In cases of combined
therapy, this period was 19.2 months for conventional surgery and gamma knife
radiosurgery, 14.0 months for surgery and radiotherapy, and 7.0 months for radiotherapy
and chemotherapy. For those with adenocarcinoma, the median survival period was 7.7
months ; those with large cell carcinoma had the shortest median survival
period(4.6months)
Combined therapy proved most effective, but survival periods did not lengthen.
키워드
Brain metastasis; Gamma knife radiosurgery;
원문 및 링크아웃 정보
등재저널 정보