厄洛替尼联合全脑放疗治疗非小细胞肺癌脑转移临床观察

Clinical observation of erlotinib combined with whole brain radiotherapy for non-small cell lung cancer patients with multiple brain metastases

目的观察厄洛替尼联合全脑放疗(WBRT)治疗非小细胞肺癌(NSCLC)脑转移的有效性和安全性。方法16例均为不能耐受化疗或化疗失败的NSCLC脑转移患者,接受WBRT(40Gy/20次,4周)并同期口服厄洛替尼150mg,每日1次,共计30d。在放疗结束后3个月复查脑MRI,观察肿瘤大小,每3个月一次进行临床疗效评价直至疾病进展,并统计1年生存情况。结果厄洛替尼联合WBRT对NSCLC脑转移的总有效[完全缓解(CR)+部分缓解(PR)]率为87.5%,临床获益率[CR+PR+疾病稳定(SD))]为100%(2例CR,12例PR,2例SD);临床症状缓解率100%;中位疾病进展时间8.3个月,中位总生存时间10个月。13例(81.3%)出现1-2级皮疹,6例(37.5%)发生轻度腹泻。结论厄洛替尼联合WBRT治疗NSCLC脑转移具有较好疗效,毒副作用轻,可耐受,生存期延长,值得临床进一步推广应用。

Objective The prognosis of patient with brain metastases from lung cancer is poor. This study aims to determine the effieacy and tolerability of erlotinib combined with whole brain radiotherapy （WBRT） for non - small cell lung eaneer（NSCLC） patients with brain metastasis. Methods Sixteen NSCLC patients with brain metastases received conventional WBRT of 40 Gy eoneurrently with erlotinib 150 mg/day for 30 days. MRI was evaluated 3 months after radiation. Results In NSCLC patients with brain metastasis, the overall response rate and clinical benefit rate of erlotinib eombined with WBRT were 87.50% and 100% respectively （ eomplete response [ CR] in 2 patient, partial response [ PR] in 12 patients, and stable disease [SD] in 2 patients）. Overall median survival was 10 months. Median time to progression was 8.3 months. Thirteen patients （81.3%） presented a grade 1 - 2 rash and six patients （ 12.5% ） experienced grade 1 diarrhea. Conclusion Erlotinib combined with radiotherapy was effective for non - small cell lung cancer patients with multiple brain metastases, and the side - effect was mild and tolerant.