预测肺癌脑转移瘤预后的列线图研究

目的建立预测肺癌脑转移瘤1年、2年、3年生存概率的列线图模型。方法收集上海交通大学医学院附属仁济医院神经外科和放射科2018年6月—2021年6月间治疗的86例肺癌脑转移瘤患者数据。使用R语言将统计学分析结果得出的独立危险因素建立列线图并验证。结果研究共纳入并完整随访86例患者的数据，统计分析显示使用靶向治疗、颅内转移灶切除以及颅内病灶放疗是影响肺癌脑转移瘤预后的独立保护因素。列线图验证结果显示C-index为0.764，1年生存预测的受试者特征曲线下面积（AUC）值为0.689、2年生存预测的AUC值为0.717、3年生存预测的AUC值分别为0.752，决策分析曲线与校准曲线拟合良好。结论本研究成功建立了个体化列线图预测肺癌脑转移瘤预后，该列线图提供了预后的有效预测信息，使临床医师得以制定个性化的随访计划，帮助家属深入了解肺癌脑转移瘤预后。

Objective To establish a nomogram model for predicting the 1-year, 2-year, and 3-year survival probability of brain metastases from lung cancer. Methods Data of 86 patients with brain metastases from lung cancer treated in the Department of Neurosurgery and Radiotherapy, Renji Hospital, Shanghai Jiaotong University, from June 2018 to June 2021 were collected. The independent risk factors derived from statistical analysis results were established and verified by using R language. Results The data of 86 patients were included and followed up. Analyses of statistics revealed that targeted treatment, surgery for intracranial occupying lesions and radiotherapy for intracranial metastases were all independent protective factors that had an effect on the prognosis of brain metastases from lung cancer. The nomogram validation results showed that the C-index was 0.764, the AUC values of 1-year survival prediction, 2-year survival prediction and 3-year survival prediction were 0.689, 0.717 and 0.752, respectively. The decision analysis curve and the calibration curve were well fitted. Conclusions This study successfully establishes an individualized nomogram to predict the prognosis of brain metastases from lung cancer. The nomogram can provide effective predictive information for prognosis, enable clinicians to formulate personalized follow-up plans, and help family members understand the prognosis of brain metastases from lung cancer.