全脑放射治疗联合康莱特治疗多发脑转移癌的疗效观察

The curative effect of whole brain radiotherapy combined with kanglaite in treatment of multiple brain metastases

目的探讨全脑放射治疗联合康莱特治疗多发脑转移癌的临床效果及安全性。方法选取2009年11月至2012年5月间收治的78例多发脑转移癌患者,将患者随机分为观察组和对照组,每组39例。对照组患者采用全脑放射治疗,观察组患者全脑放射治疗联合康莱特治疗,观察两组患者治疗后客观缓解率(ORR)和不良反应发生情况。结果观察组和对照组患者完成放射治疗者分别为38例和36例,其中观察组患者经治疗后完全缓解(CR)4例,部分缓解(PR)18例,病灶稳定(SD)14例,病情进展(PD)2例,客观缓解率为57.9%;而对照组患者CR 0例,PR 14例,SD 12例,PD 10例,客观缓解率为38.9%,两组差异有统计学意义(P<0.05)。治疗过程中,观察组患者出现骨髓抑制2例,主要表现为白细胞和粒细胞减少,脱发2例,其他3例,不良反应发生率为18.4%;而对照组患者出现骨髓抑制5例,脱发6例,其他9例,不良反应发生率为55.6%,两组差异有统计学意义(P<0.05)。结论全脑放射治疗联合康莱特治疗多发脑转移癌具有较好的疗效,不良反应少,值得临床推荐使用。

Objective To analysis the clinical effect of kanglaite（KLT） combined whole brain ra- diotherapy treatment of multiple brain metastases. Methods 78 patients with multiple brain metastases ad- mitted to our hospital from October 2009 to May 2012 were studied. Control group was treated with whole brain radiation therapy, and observation group added joint KLT. Observed objective response rate （ORR） and the side effects that occur during radiation therapy were to be observed, and comparatively analyszed. Results Observation group and control group patients completed radiation therapy were 38 cases and 36 ca- ses,including the observation group after treatment, complete remission （CR） for the four cases, partial re- mission （PR） 18 cases,lesions stable （SD） 14 cases of the disease progress （PD） 2 cases, the objective response rate was 57.9%, while the control group complete remission （CR） was 0 cases, partial remission （PR） 14 cases,lesions stable （SD） 12 cases of disease progression （PD） 10 cases whose objective re- sponse rate 38.9%, compared to the two groups, the difference was significant, （ P 〈 0. 05 ）. Observed during the treatment group had two cases of bone marrow suppression, primarily manifested as neutropenia and neu- tropenia,alopecia 2 cases, the other 3 cases, the incidence of adverse reactions, 18.4%, while the control group had 5 cases of bone marrow transplant ,6 cases of alopecia,the other nine cases, adverse reactions was 55.6%, compared to the two groups, the difference was significant （ P 〈 0. 05 ）. Conclusions KLT com- bined whole brain radiotherapy treatment of muhiple brain metastases have better efficacy, and lower adverse reactions. It is recommended for cfinical use.