替加氟同步放疗治疗消化道肿瘤脑转移效果观察

Clinical effect of ftorafur therapy on brain metastasis from gastrointestinal tract

目的观察替加氟同步放疗治疗消化道肿瘤脑转移的疗效及不良反应。方法将43例消化道肿瘤脑转移患者随机分为观察组和对照组,对照组采用全脑普照30 Gy后,局部补量至50 Gy,观察组在静脉滴注替加氟1.0 g后30 min以上行放疗,通过随访及定期MRI检查观察生存时间、脑部转移灶复发率、原发病灶复发、未控和(或)非脑部器官转移率、半年及1年生存率和不良反应的发生率等指标的变化。结果观察组及对照组中位生存期分别为13、9个月(χ2=10.282,P=0.001);1年生存率分别为53.4%、27.3%(χ2=6.85,P=0.009);脑部转移灶复发率分别为9.5%、45.5%(χ2=5.22,P<0.05);骨髓抑制发生率分别为85.7%、40.9%(χ2=7.41,P<0.05);消化道反应发生率分别为61.9%、10%(χ2=10.97,P<0.05),两组比较,差异均有统计学意义。结论替加氟同步放疗能够提高消化道肿瘤脑转移患者的1年生存率,降低脑部转移灶的发生率;替加氟同步放疗增加了患者的骨髓抑制和消化道反应发生率,但经对症处理后均能缓解。

Objective To study the efficacy and adverse reactions of ftorafur with synchronous radiation therapy on brain metastasis from gastrointestinal tract.Methods Forty-three patients were divided into observation group and control group.The control group received 30 Gy whole brain irradiation and amount local suppltmentary to 50 Gy,before more than half an hour.Observation group received intravenous infusion of ftorafur 1.0 g.Through follow-up and periodic MRI examination to observe average survival time,the recurrence rates of brain metastasis focus,the primary recurrence rates,uncontrolled and / or brain metastasis rates,half and one year survival rates and the incidence of adverse reactions.Results In observation group and control group,the median survival time were 13 months and 9 months（χ2=10.282,P=0.001）;53.4% and 27.3% for the one-year survival rates（χ2=6.85,P=0.009）;9.5% and 45.5% for the recurrence rates of brain metastasis（χ2=5.22,P〈0.05）;85.7% and 40.9% for myelosuppression（χ2=7.41,P〈0.05）;61.9% and 10% for gastrointestinal reactions（χ2=10.97,P〈0.05）;the differences were significant.Conclusion Ftorafur with synchronous radiation therapy for brain metastasis from gastrointestinal tract improves the one year survival rate and reduces the incidence of brain metastases.But the bone marrow suppression incidence and gastrointestinal reaction rates are increased;the gastrointestinal reaction can be alleviated by symptomatic treatment.