| Objective: Malignant tumor of brain metastases are the most commonintracranial tumor, metastatic brain tumor incidence increases year by year,and has the characteristics of short duration, severe illness, has become themajor threats to human health. In recent years, although the brain metastasistherapy in the unceasing progress, but there is no reasonable, standardizedtreatment model, the research concerned is worth thinking. The researchpublished at home and abroad to retrieve the related brain metastases in thetreatment, the best treatment method using Meta analysis of brain metastases.And the combination of clinical and pathological data of our hospital, patientswith brain metastasis were analyzed, designed to further optimize the strategyfor the treatment of brain metastases.Methods:1Brain metastasis tumor treatment method for the analysis of Meta model1.1Retrieval strategy: to Chinese keywords "brain metastases,""treatment","radiation","chemotherapy","operation","molecular targeted drugs","brainmetastases","radiotherapy","chemotherapy","molecular target therapy","surgical" search the database.1.2Quality evaluation: according to jadid score assessment of study quality.1.3Statistical processing: complete data were analyzed by RevMan5.0software.2Clinical data of patients with brain metastasis tumor2.12007February-2012February collected in the fourth hospital of HebeiMedical University, has tumor imaging and pathology cytologic diagnosis in404cases of cerebral metastasis in patients with clinical pathological data,including age, sex, primary pathology, brain metastasis diagnosed inspection,a number of brain metastases, clinical manifestations, other sites of metastasis,the treatment of the primary disease brain metastases tumor, treatment and history.404patients were collected in2.2, the follow-up to301cases, analysis of thelost cases without statistics, according to301cases patients with cerebralmetastases to the different treatments will be followed to is divided into:comprehensive treatment group, the single treatment group, systemic and localtreatment, systemic therapy, local treatment group, group molecular targeteddrug therapy group and non targeted therapy group.2.3Retrospective analysis of the impact of brain metastasis and survival inpatients with.2.4Survival from brain metastases day to day of death, survival follow-updeadline, the follow-up deadline is2012-12-30. This study did not lost tofollow-up were statistical survival analysis.2.5Of all were analyzed by statistical software SPSS13.0. Count data usingX2test, univariate, multivariate analysis using COX proportional hazardmodel, survival analysis method using Kaplan-Meier. All data inP<0.05is astatistically significant difference.Results:1The results of Meta analysis: After were screened out in Chinese andEnglish literature of352references the computer retrieval, by reading thequestion, abstract, text, a total of26papers were included. Meta analysisshowed that, compared with the single treatment, comprehensive treatmentcan improve the patients survival rate of1years (with OR=0.58,95%CI:0.46-0.71, P<0.00001), the half year survival rate (with OR=0.75,95%CI:0.66-0.85, P<0.00001); in the treatment group, compared with the2kindsof combination therapy,3kinds of combined treatment can improve thepatients survival rate in1years (with OR=0.63,95%CI:0.50-0.80, P=0.0001),the half year survival rate (with OR=0.59,95%CI:0.47-0.74, P<0.00001);compared with local treatment, systemic and local treatment can improve thepatients1years survival rate ($and OR=0.68,95%CI:0.53-0.86, P=0.001), thehalf year survival rate (with OR=0.80,95%CI:0.67-0.96, P=0.02); comparedwith systemic therapy, systemic and local treatment can improve the patients the1year survival rate (with OR=0.59,95%CI:0.41-0.86, P=0.006), the halfyear survival rate (with OR=0.72,95%CI:0.62-0.84, P<0.0001); in general andlocal treatment, compared with the2treatments,3kinds of treatment canimprove the patients survival rate of1years (with OR=0.52,95%CI:0.35-0.78,P=0.002), the half year survival rate (with OR=0.57,95%CI:0.41-0.78, P=0.0005); compared with the non targeted therapy, molecular targeted drug therapycan improve the target with a1year survival rate (with OR=0.76,95%CI:0.67-0.87, P<0.0001), the half year survival rate (with OR=0.90,95%CI:0.84-0.96, P=0.003).2Survival comparison: compared with single treatment, comprehensivetreatment can improve the median survival of patients and the average survivaltime (P<0.05); in the treatment group, compared with2for combinationtherapy,3kinds of combined treatment can improve the median survival ofpatients and the average survival time (P<0.05); compared with local,systemic treatment, systemic and local treatment can improve the mediansurvival of patients and the average survival time (P<0.05); in general andlocal treatment, compared with the2kinds of treatment,3treatment canimprove the median survival of patients and the average survival time(P<0.05); compared with the non targeted therapy, molecular targeted therapycan improve the targeting of the median survival of patients and the averagesurvival time (P<0.05).3Analysis of prognostic factors: age, primary tumor pathological subtypeinfluences the prognosis of brain metastases were independent factors, age lessthan or equal to65years old patient survival (P=0.032), longer survival inlung adenocarcinoma patients survival compared with other pathological typesof long (P=0.005).Conclusions:1In metastatic brain tumor patients, comprehensive treatment to increase thesurvival rate of the patients is better than that of single treatment.2To take comprehensive treatment,3or more than3kinds of combinationtherapy is better than2ways of combination therapy. 3For brain metastases, systemic therapy combined with local treatment ofbrain tumor metastasis in improving survival rate than the local treatment ofsimple systemic therapy or brain metastases.4To take a systemic and local treatment,3treatments in improving survivalrate is better than that of2kinds of treatment methods combined with.5For patients with lung cancer, breast cancer, molecular targeted drugs inimproving the survival rate of patients with brain metastases, significantlybetter than targeting therapy.6The best treatment for brain metastases, radiotherapy, chemotherapy andoperation mode for3kinds of treatment with systemic and local treatment,which, if has the application of molecular targeted drug indications, in theoriginal solution based on the combined molecular target drug effect.7Age and primary tumor pathological subtype were independent factorsaffecting the prognosis of patients with brain metastases. |
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