吉非替尼联合放疗治疗非小细胞肺癌脑转移疗效观察

Effects of Gefitinib Combined with Whole Brain Radiation on Brain Metastasis from Non-small-cell Lung Cancer

目的探讨吉非替尼联合全脑放疗(WBRT)治疗非小细胞肺癌(NSCLC)脑转移的疗效。方法将53例NSCLC脑转移患者按治疗方法分为两组:试验组35例,吉非替尼联合WBRT治疗;对照组18例,单用WBRT治疗。吉非替尼均采用治疗第1天开始口服,每日250 mg,直到病变进展或其他原因停药。WBRT均从治疗第1天开始,单次周边剂量2 Gy,治疗总剂量为40 Gy,治疗次数20次,5次/周。于治疗前后对比两组间的治疗效果以及不良反应。结果试验组35例患者中,PR 21例,PD 1例,RR 77.2%,DCR 97.2%,中位生存期12.1个月,1年生存率68.6%;对照组PR 5例,PD 5例,RR 38.9%,DCR 72.2%,中位生存期9.8个月,1年生存率27.8%;吉非替尼联合WBRT组在近期疗效(RR及DCR)及远期疗效(1年生存率)方面均高于单纯WBRT组(P=0.014,0.016,0.000)。结论吉非替尼联合WBRT治疗NSCLC脑转移具有较好的近期及远期疗效。

Objective To evaluate the efficacy of gefitinib combined with whole brain radiation（WBRT） on the brain metastasis from non-small-cell lung cancer（NSCLC）.Methods Fifty three cases of brain metastases from NSCLC were divided into two groups according to treatment： the experimental group（35 cases） received gefitinib combined WBRT,while the control group（18 cases） received WBRT only.Gefitinib was administered orally from the first day of treatment,250 mg daily,until the disease was improved or withdrawal for other reasons.WBRT were administered from the 1st day of treatment,a single peripheral dose was 2 Gy,and total dose was 40 Gy,number of treatment was 20 times,5 times every week.The curative efficacy and adverse reactions were observed and compared.Results In the experimental group,21 cases were with PR,1 case with PD,RR was 77.2% and DCR was 97.2%,the median survival time was 12.1 months,one year survival rate was 68.8%.In the control group,5 cases were with PR,5 cases with PD,RR was 38.9% and DCR was 72.2%,the median survival time was 9.8 months,one year survival rate was 27.8%.The short-term therapeutic effect（RR and DCR） and long-term effect（1-year survival rate） of the experimental group were better than the control group（P=0.014,0.016,0.000）.Conclusion Gefitinib combined with WBRT for brain metastases from NSCLC have a better short and long term efficacy.