同期放疗联合表皮生长因子受体-酪氨酸激酶抑制剂治疗非小细胞肺癌脑转移的研究进展

Research progress of radiotherapy combined with EGFR-TKI in the treatment of brain metastasisfrom lung cancer

脑转移是肺癌患者疾病进展的一个普遍以及灾难性的后果。表皮生长因子受体-酪氨酸激酶抑制剂（EGFR—TKI）通过降低S期细胞的比例、减少肿瘤血管形成、引起凋亡增加、抑制分次照射中肿瘤细胞再增殖、降低辐射抗性等途径，发挥对放疗的增敏作用。同期放疗联合EGFR—TKI（如吉非替尼等）治疗非小细胞肺癌（NSCLC）脑转移患者的临床研究显示其有更高的有效率、更长的生存期。EGFR-TKI自身毒性相对较低，患者发生不良反应后经对症治疗多数可好转，与放疗联合应用时对放疗影响较小。

Brain metastasis is a common and devastating consequence of disease progression in patients with lung cancer. Epidermal growth factor receptor-tyrosine kinase inhibitors （EGFR-TKI） may enhance radiosensitivity by reducing the cells in S phase, reducing angiogenesis of tumor cells, increasing irradiation apoptosis, inhibiting tumor ceils proliferation by fractionated irradiation and reducing radiotherapy resistance. The clinical results of radiotherapy combined with EGFR-TKI （such as gefitinib） in treatment of brain metastasis from lung cancer showed higher response rate and longer survival. The toxicities during EGFR-TKI treatments were low, and could be controllable after symptomatic treatment. Administration of EGFR-TKI combined radiotherapy conferred minimum influence on radiotherapy.