[求助]大家帮帮我，看看我爸的病情肺腺癌单发脑转移

legenddad

我爸因流虚汗去检查，左肺炎症，右肺下叶有一个肿块，当时怀疑是结核球，后来打了十几天针好了，炎症消了，但肿块没消，去济南省立医院做全身体检，他三个月来不时出现视力模糊，一年多睡觉时有幻觉，脑枕叶有一个转移灶，脑部在枕叶，1.１×１.３,周围水肿不重，肺部才2.0 乘2.6大，建议先做脑部手术，然后是肺手术，后化疗，现在做完了脑手术，他骨无转移，淋巴结也不肿大，转移也太快了，他才53岁呀，才手术十五天就再做肺是不是太快了？他其他都很正常，没做pet，医生说国际惯例是如果脑和肺都是单发，就可做手术，我查得资料也是这么说的。还有肺部也不是肺叶全切，我认为这是一个最大的错误，那该怎么补救呀，还有病理已经出来了，是高-中分化腺癌，预后怎么样呀，这些庸医太可恶了，不全切肺叶，唉，亏我还是个医学生，当时光在医院忙了，没来得及在学校查专业资料

高中分化是不是比较罕见呀，看论坛里朋友们的亲属都是低中分化，听说分化越高化疗越不敏感，虽然分化高，但病灶这么小就转移恶性程度还是很高的

下一步是全脑放疗还是先化疗，我考虑他的分化比较好，应该可以认为就一个转移，可以先全身化疗（能通过血脑屏障的），然后再脑放疗 如果化疗用什么药呀？

大家帮我分析一下，好吗？到底是全脑还是立体三维好，先化疗还是放疗好难抉择呀

清泉石上流

自己本身就是医学院的学生的话,也可以去咨询一下老师什么的啊,比我们的途径要多呢.

legenddad

那也要看什么样的老师了，我问老师都不让做手术呢，说人财两空 晕

legenddad

Pulmonary resection in patients with nonsmall-cell lung cancer treated with gamma-knife radiosurgery for synchronous brain metastases.

Yang SY, Kim DG, Lee SH, Chung HT, Paek SH, Hyun Kim J, Jung HW, Han DH.

Department of Neurosurgery, DongGuk University International Hospital, Gyeonggi-do, Korea.

BACKGROUND: The aim of the current study was to determine whether a pulmonary resection and gamma-knife radiosurgery (GKRS) protocol is superior to GKRS alone in selected patients with stage IV nonsmall-cell lung cancer (NSCLC). METHODS: The authors performed a retrospective case-control study of 232 consecutive patients with newly diagnosed NSCLC from January 1998 to December 2005 and screened them to identify a study cohort in which all patients had thoracic stage I or II, Karnofsky performance status >or= 70, no extracranial metastases, and 1-3 synchronous brain metastases of less than 3 cm, and were treated with GKRS (n=31). The study cohort was divided into 2 groups, those with and without concomitant pulmonary resection. RESULTS: Sixteen patients with pulmonary resection were assigned to the treatment group and 15 without pulmonary resection were assigned to the control group. Median follow-up was 27.3 months (range, 4.4 months to 90.9 months). Mean survivals for the treatment group and the control group were 64.9 and 18.1 months, respectively (P< .001). There was a statistically significant association between pulmonary resection and better survival (OR=78.408). One-year and 5-year local brain tumor control rates were 97.1% and 93.5%, respectively. CONCLUSIONS: The pulmonary resection and GKRS protocol could prolong survival in patients with thoracic stage I or II NSCLC, no extracranial metastases, and a limited number of small synchronous brain metastases.

全文我在学校的cancer上看过了，如果肺部一期76个月，二期56月，太让我激动了，我真怕造假呀，以前查的资料都只有20-30%，国内更低

wsygb2001

脑部病灶不大，别手术了，赶紧放化疗