紫杉醇、替尼泊苷及顺铂化疗同步放疗治疗肺癌脑转移

Concomitant Whole Brain Radiotherapy and VM26+DDP+PTX Chemotherapy in Brain Metastasis of Lung Cancer

目的观察紫杉醇、替尼泊苷及顺铂化疗同步全脑放疗治疗肺癌脑转移的临床疗效及毒副反应。方法48例肺癌脑转移实施全脑放疗，放疗剂量30Gy，每次3Gy，5次／周；或40Gy，每次2Gy，5次／周。于全脑放疗5次后开始进行紫杉醇、替尼泊苷及顺铂联合化疗，化疗28d为1周期，共进行2周期。结果48例总有效率为68．7％，其中CR12例，PR21例，NC12例，PD3例，中位生存期11．0个月，1年生存率43．75％。对脑转移引起的颅内高压所致头疼缓解16／18例，恶心呕吐好转30／37例，神经系统症状好转19／37例。主要毒副反应有骨髓抑制，Ⅰ-Ⅱ度白细胞减少37例，Ⅲ～Ⅳ度10例，血小板减少21例；Ⅰ—Ⅱ度恶心呕吐22例，Ⅲ-Ⅳ度12例；Ⅰ-Ⅱ度神经毒性10例；所有患者均出现不同程度的脱发，无肝肾功能损害和过敏反应发生。结论全脑放疗同步PTX＋VM26＋DDP化疗治疗肺癌脑转移疗效较好，毒副反应小，患者可耐受全程治疗，值得进一步研究。

Objective To observe the efficacy and toxicity of concomitant chemoradiotherapy in patients with brain metastasis from lung cancer. Methods Forty-eight patients suffering from lung cancer with brain metastasis were included in this study. The treatment consisted of concomitant whole brain radiotherapy（WBRT） with a dose of 30 Gy in 10 fractions or 40 Gy in 20 fractions. The concomitant chemotherapy of VM26 ＋ DDP ＋ PTX after 1 week,repeating every 28 days. The efficacy was evaluated on 2 cycles. Results The overall response rates were 68.7% ,CR 12 patients, PR 21 patients, NC 12 patients,PD 3 patients, the average period of survival was 11.0 months, the 1-year survival rate was 43.75%. The main toxicities were myelosuppression, nausea and vomiting, alopecia, and other side effects were mild. There were not any impaired liver and renal function, and anaphylaxis. Conclusion Concomitant WBRT and VM26 ＋ DDP ＋ PTX chemotherapy can be performed for the patients with brain metastasis from lung cancer with a remarkable response rate.