替莫唑胺联合全脑放疗治疗非小细胞肺癌脑转移瘤的近期临床疗效观察

Temozolomide combined with whole-brain radiotherapy in treatment of non-small cell lung cancer complicated with metastatic brain tumor

目的 观察替莫唑胺联合全脑放疗治疗非小细胞肺癌脑转移患者的临床疗效及安全性.方法 回顾分析了确诊非小细胞肺癌脑转移的患者32例,予以常规分割性全脑放疗,剂量DT 40 Gy （2Gy,1次/d,每周5d）,放疗期间每日口服替莫唑胺75 mg,/（m2·d）,放疗结束后每4周予以替莫唑胺200 mg/ （m2·d）口服5d方案化疗,共6周期.生存率使用Kaplan-Meier方法计算.结果 32例患者均可评价疗效,其中完全缓解5例（15.6％）,部分缓解19例（59.3％）,稳定4例（12.5％）,进展4例（12.5％）,近期治疗有效率74.9％,临床获益率87.4％,中位生存期7.6个月.治疗的不良反应主要表现为胃肠道症状、骨髓抑制,患者均可耐受.结论 替莫唑胺联合全脑放疗方案治疗非小细胞肺癌脑转移患者有较好的近期疗效及安全性,值得在临床进一步使用.

Objective To observe the therapeutic effect and toxicity of temozolomide combined with whole-brain radiotherapy in the treatment of non-small cell lung cancer complicated with metastatic brain tumor.Methods 32 patients with non-small cell lung cancer who were diagnosed with brain metastases orally took temozolomide （75mg/m2·d） and received 40 Gy fractionated conventional external-beam radiotherapy （2 Gy per day,5 days per week） for 4 weeks.After radiotherapy,patients took temozolomide （200mg/m2·d） for 5 days every 4 weeks for 6 cycles.Progression-free survival curves and overall were estimated by Kaplan-Meier technique.Results All the 32 patients were evaluable for response with 5 cases of CR,19 PR,4 SD,and 4 PD.The overall response rate was 74.9% and the clinical benefit rate was 87.4%.The median progression-free survival time was 7.6 months.The main side effects were gastrointestinal reaction and myelosuppression,which were alleviated by symptomatic treatment.Conclusions Temozolomide combined with whole-brain radiotherapy is effective with mild toxicity for patients with non-small cell lung cancer who were diagnosed with brain metastases.