摘要目的:评估全脑放疗(WBRT)在非小细胞肺癌脑膜转移(NSCLC-LM)的作用。方法:回顾分析2014—2019年间在广东三九脑科医院收治的80例经细胞学和/或影像学证实为NSCLC-LM患者临床资料。EGFR突变阳性者49例，野生型者31例。WBRT者38例，非WBRT者42例。 Kaplan- Meier法生存分析， Cox模型预后因素分析。 结果:全组患者中位总生存(mOS)为8.0个月(4.4~11.6个月)，1年OS率为39%。EGFR突变阳性者比野生型者的mOS长(12.6个月∶4.1个月， P<0.001)；年龄<53.5岁比≥53.5岁者的mOS更长(12.6个月∶6.1个月， P＝0.041)。WBRT与非WBRT对EGFR突变阳性者的mOS无差异(12.6个月∶25.9个月， P＝0.490)，对野生型者的mOS延长(8.0个月∶2.1个月， P＝0.002)。多因素分析显示年龄较小( P＝0.048)、WBRT( P＝0.025)是EGFR野生型NSCLC-LM患者有利的预后因素。 结论:WBRT给EGFR野生型NSCLC-LM患者带来生存获益，因此推荐可对NSCLC-LM患者进行分子生物学分层基础上的WBRT。

abstractsObjective:To evaluate the role of whole-brain radiation therapy (WBRT) in meningeal metastasis (LM) in non-small-cell lung cancer(NSCLC).Methods:From December 2014 to March 2019, eighty NSCLC patients with cytologically and/or radiologically proven LM diagnosis were retrospectively analyzed.49 patients had positive for EGFR mutations, and 31 patients were in wild-type patients. 38 patients were used to WBRT, with 42 non-WBRT. The survival analysis was played by Kaplan- Meier method. Prognostic factors analysis was played by Cox model. Results:All patients median overall survival (mOS) was 8.0(95% CI: 4.4-11.6) months, and the one-year OS was 39%. The mOS for EGFR-mutated LM patients was 12.6 months versus only 4.1 months for patients with wild-type EGFR ( P<0.001). Younger patients (<53.5 yrs.) appeared to have a better OS than older patients (≥53.5 yrs.) (12.6 months vs. 6.1 months, P=0.041). No survival benefits were found in EGFR-mutated patients who received WBRT (12.6 months vs. 25.9 months, P=0.490). In contrast, mOS was significantly prolonged in wild-type EGFR patients with WBRT versus non-WBRT (mOS: 8.0 months vs. 2.1 months, P=0.002). Multivariate analysis indicated that WBRT ( P=0.025) and younger age ( P=0.048) were independent prognostic factors that predicted prolonged survival for wild-type EGFR LM patients from NSCLC. Conclusion:WBRT has clear survival advantages for patients with wild-type EGFR, and molecular biological stratification of LM patients for WBRT may be highly recommended.