伽玛刀联合替莫唑胺治疗非小细胞型肺癌脑转移瘤的临床疗效观察

Clinical observation of gamma knife combinated with temozolomide for non-small cell lung cancer patient with brain metastasis

目的探讨伽玛刀联合替莫唑胺(TMZ)治疗非小细胞型肺癌脑转移瘤的有效性和安全性。方法 2010年1月～2012年6月收治于我院的48例术后病理确诊为非小细胞型肺癌(NSCLC)脑转移瘤患者,随机分为三组,每组16例患者,A组患者为伽玛刀联合替莫唑胺治疗组,B组为单独伽玛刀治疗组,C组为伽玛刀联合全脑放疗组,治疗期间观察记录患者的临床疗效及毒副反应,直至疾病进展,记录患者的预后生存情况。结果伽玛刀联合替莫唑胺治疗组的总有效[完全缓解(CR)+部分缓解(PR)]率为81.3%,局部控制[CR+PR+疾病稳定(SD)]率为93.7%,术后一年生存率56.3%,中位生存时间11个月;主要副作用表现为骨髓抑制。结论伽玛刀联合替莫唑胺(TMZ)对非小细胞型肺癌脑转移瘤有较好的疗效和安全性,但总生存率无明显差异。

Objective To observe the clinical efficacy and toxic effect of gamma knife and TMZ combination for brain metastasis from NSCLC. Methods 48 patients were enrollde who were diagnosed to be NSCLC with brain metastasis by histological evidence in our department from2010 to2012.They were divide into three groups,16 patients in group A were chemothrapied by TMZ after gamma knife radiosurgery,The 16 patient of group B were only treated by gamma knife radiosurgery.And the 16 patient in group C were received gamma knife radiosurgery plus WBRT.Then analysed the difference of 3groups. Results The overall response rate in group A is 81.3%,the local control rate is 93.7%,the survival rate for one year is 56.3%,Myelosuppression is the most common dose-limiting toxicities. Conclusion Temozolomide ally gamma knife radiosurgery have some response rate and local control rate in the treatment of NSCLC patient with brain metastasis.