全脑放疗联合靶向治疗与同步放、化疗治疗非小细胞肺癌脑转移疗效分析

Therapeutic effects of whole brain radiotherapy with targeted therapy and concomitant chemo-radiotherapy in treatment of non-small-cell lung cancer with brain metastasis

目的比较全脑放疗联合靶向治疗与同步放、化疗治疗非小细胞肺癌(NSCLC)脑转移的近期疗效、远期生存率及不良反应。方法对58例NSCLC脑转移患者的临床资料进行回顾性分析。36例患者接受全脑放疗联合靶向治疗(每日口服吉非替尼250 mg或厄洛替尼150 mg),22例患者接受全脑放疗及含铂为主的同步化疗。用Kaplan Meier法和Logrank法对患者进行生存分析,并比较两组之间的疗效差异。结果全脑放疗联合靶向治疗组疾病控制率为66.7%,同步放、化疗组疾病控制率为36.4%,全脑放疗联合靶向治疗组明显高于同步放化疗组(P<0.05)。全脑放疗联合靶向治疗组1年生存率为68%,中位生存期23.2个月。同步放、化疗组1年生存率为41%,中位生存期7.1个月。全脑放疗联合靶向治疗组中位生存期优于同步放、化疗组(P<0.05)。结论全脑放疗联合靶向治疗NSCLC脑转移的疾病控制率高于同步放、化疗,且患者生存时间延长。

Objective To compare the short-term therapeutic effects, long-term survival and adverse effects between whole brain radiotherapy with targeted therapy and concomitant chemo-radiotherapy in treatment of non-small-cell lung cancer （NSCLC） with brain metastasis. Methods The clinical data of 58 patients with NSCLC with brain metastasis were retrospectively analysed. Thirty-six patients received whole brain radiotherapy with targeted therapy （oral administration of gefitinib 250 mg or erlotinib 150 mg per day）, and the other 22 patients received whole brain radiotherapy with concomitant chemotherapy （platinum-based regimen）. Survival analysis was conducted in two groups with Kaplan Meier method and Logrank test, and the differences in therapeutic effects were explored between two groups. Results The disease control rate in whole brain radiotherapy with targeted therapy group was significantly higher than that in concomitant chemo- radiotherapy group （66.7% vs 36.4%, P 〈 0.05）. The 1-year survival rate in whole brain radiotherapy with targeted therapy group was 68%, and the median duration of survival was 23.2 months. The 1-year survival rate in concomitant chemo-radiotherapy group was 41%, and the median duration of survival was 7.1 months. The median duration of survival in whole brain radiotherapy with targeted therapy group was significantly longer than that in concomitant chemo-radiotherapy group （P 〈 0.05）. Conclusion Whole brain radiotherapy with targeted therapy is superior to concomitant chcmo- radiotherapy in disease control rate and duration of survival for treatment of NSCLC with brain metastasis.