颅脑放疗联合替莫唑胺治疗非小细胞肺癌脑转移30例

Whole Brain Radiotherapy Combined with Temozolomide in the Treatment of 30 Cases with Brain Metastasis from Nonsmall Cell Lung Cancer

[目的]观察全脑放疗与全脑放疗联合替莫唑胺治疗非小细胞肺癌（non-small cell lung cancer，NSCLC）脑转移的疗效、生存时间及不良反应。[方法]60例NSCLC伴脑转移患者随机分为放射治疗组（放疗组30例）和放射治疗联合化疗组（联合组30例）。放疗组：全脑放疗剂量D，40Gy／20F／4W。联合组：放疗方法与放疗组相同，放疗同步替莫唑胺治疗剂量为75mg／（m。·d），dlm。[结果]放疗组和联合组总有效率分别为43.3％（13／30）、63.3％（19／30）（P=0．07）；中位生存时间放疗组为4．3个月，联合组为8．5个月（P〈0．01）。联合组骨髓抑制和胃肠反应高于放疗组（P〉0．05）。[结论]全脑放疗联合替莫唑胺可以作为NSCLC脑转移患者的治疗选择．治疗不良反应可耐受。

[Purposel To investigate the therapeutic effect,survival and toxicity of whole brain ra- diotherapy alone or radiotherapy combined with temozolomide （TMZ） in the treatment of brain metastases from non-small cell lung cancer（NSCLC）. [Methods] Sixty NSCLC patients with brain metastasis were randomly divided into radiotherapy group （30 cases） and chemoradiotherapy group （combination group, 30 cases） ： radiotherapy group with whole brain conventional radiothera- py dose D＋40Gy/20F/4W ;combination group with the same radiation method as the radiotherapy group,concurrent with TMZ dose of 75 mg/（m2·d）,d1-28. [Results] The response rate of radiother- apy group and combination group was 43.3%（13/30） and 63.3%（19/30）（P=0.07） respectively;and the median survival was 4.3 months and 8.5 months （P〈0.01） respectively. Bone marrow suppres- sion and gastrointestinal toxicities in combination group were higher than those in the radiothera- py group（P〉0.05 ）. [ Conclusion ] Whole brain radiotherapy combined with TMZ might be used as a treatment option for NSCLC patients with brain metastasis, with tolerable toxicities.