目的：探讨影响肺癌脑转移综合治疗的预后因素及提高生存质量的可能性。方法：１９９０ 年３月～１９９５ 年３ 月间对６５ 例肺癌脑转移患者行单纯放疗及手术切除加放疗。放疗（ 全脑） 分为２ 组：常规放疗剂量２２ ～４０ Ｇｙ／２ ．２ ～４ｗ ，后缩野追加１５ ～２０ Ｇｙ／１ ．５ ～２ｗ ；全脑快速照射剂量１８ ～２４ Ｇｙ／１１ ～１５ｗ ，后缩野追加１５ ～２０ Ｇｙ／１５ ～２０ｗ 。结果：手术切除加放疗的中位生存期９５ 个月和１ 年生存率６２３ ％ ，显著优于单放组的５５ 个月和１４５ ％ （ Ｐ＜ ００５） 。全脑快速照射能迅速缓解症状，未能提高生存率。结论：肺癌脑转移采用手术加放疗的疗效比单纯放疗好。 Objective: To explore the prognostic factors affecting the comprehensive treatment of brain metastases of lung cancer and the possibility of improving the quality of life. Methods: From March 1990 to March 1995, 65 patients with brain metastases of lung cancer underwent radiotherapy and surgical resection plus radiotherapy. Radiotherapy (whole brain) is divided into two groups: conventional radiotherapy dose 22 ~ 40 Gy / 2. 2 ~ 4w, after shrinkage additional 15 ~ 20 Gy / 1. 5 ~ 2w; whole brain rapid irradiation dose 18 ~ 24 Gy / 1  1 ~ 1  5w, after shrinkage additional 15 ~ 20 Gy / 1  5 ~ 2  0w. Results: The median survival time of surgical resection plus radiotherapy was 9.5 months and the one-year survival rate was 623%, which was significantly better than that of 5 ± 5 months and 145% (P <005) . Rapid whole brain irradiation can quickly relieve symptoms, failed to improve the survival rate. Conclusion: The efficacy of surgery plus radiotherapy for brain metastases of lung cancer is better than radiotherapy alone.