改良INP方案对肺腺癌脑转移患者的疗效分析

Efficacy of chemotherapy of modified INP regimen for adenocarcinoma with brain metastases

目的观察改良INP方案对肺腺癌伴有脑转移患者的临床疗效及毒副作用,并探讨该方案疗效与Ⅲ型β微管蛋白(β-tubulin-Ⅲ)在肺癌组织中表达水平的关系。方法收集2010年4月—2013年1月广州医科大学附属第一医院胸外科收治的15例肺腺癌伴有脑转移患者的临床资料。所有患者均采用改良INP方案治疗,使用RECIST 1.0标准进行判定。结果脑转移瘤取得CR 1例(1/15),PR 5例(5/15),SD 4例(4/15),PD 5例(5/10),该方案对脑转移瘤的总缓解率(overall response rate,ORR)为40%,疾病控制率(disease control rate,DCR)达66.7%,毒副作用轻度可控;Ⅲ型β微管蛋白低表达对该方案的疗效有优于高表达的趋势。结论肺腺癌伴有脑转移患者采用改良INP方案进行化疗,脑转移瘤临床疾病控制率较高,耐受性良好;肿瘤组织β-tubulin-Ⅲ表达水平可能与该方案的疗效相关。

Objective To investigate the efficacy and toxicity of chemotherapy of modified INP regimen in the treatment of adenocarcinoma with brain metastases. At the same time, to explore the relationship between expression of β-tubulin-Ⅲ in NSCLC biopsies and sensitivity to this modified INP regimen. Methods The clinical data of 15 adenocarcinoma with brain metastases patients who had been admitted to the first affiliated hospital of Guangzhou medical university from April 2010 to January 2013 were retrospectively analyzed. All patients received modified INP regimen. RECIST 1.0 was taken to know the result. Resuits For brain metastasis of the 15 patients, complete response （CR） and partial response （PR） were 1 and 5 patients, respectively. 4 patients were stable disease （SD） and progression disease （PD） in 5 patients. The overall response rate （ORR） was 40% and the disease control rate （DCR） was 66. 7%. The toxicity was mild. Furthermore, we found NSCLC patients with low β-tubulin-Ⅲ expression had better ORR than those with high expression. Conclusion The modified INP regimen is effective and well-tolerable for brain metastases of adenocarcinoma. The β-tubulin- Ⅲ expression may be associated with the efficacy of this regimen.