吉非替尼联合全脑放疗治疗非小细胞肺癌脑转移的疗效分析

Efficacy of Iressa Joint Whole Brain Radiation Therapy for Non-small Cell Lung Cancer with Brain Metastases

目的采用吉非替尼联合全脑放疗治疗非小细胞肺癌脑转移患者,分析其治疗效果。方法选取非小细胞肺癌发生脑转移的患者,实验组患者行吉非替尼联合全脑放疗,对照组仅进行全脑放疗,于治疗前、放疗结束、放疗结束后3个月行头MRI、胸部CT明确肿瘤情况,进行疗效评价,比较其生活质量评分(KPS)、中位生存时间、1年生存率、不良反应。结果实验组完全缓解(CR)5例,部分缓解(PR)18例,稳定(SD)6例,进展(PD)1例,有效率(RR)为76.7%,疾病控制率(DCR)为96.7%,高于对照组,差异有统计学意义(P<0.05);治疗后实验组KPS评分达(74.5±7.1)分,KPS≥10分占63.3%,中位生存时间为12.2个月,1年生存率为43.3%,均明显高于对照组,差异有统计学意义(P<0.05)。2组患者均出现皮疹、恶心、呕吐、腹泻、白细胞下降、转氨酶升高、骨髓抑制等不良反应,实验组的皮疹、恶心、呕吐、骨髓抑制发生率与对照组比较,差异有统计学意义(P<0.05)。实验组1个月生存率93.3%,3个月生存率76.7%,6个月生存率66.7%,1年生存率50.0%,均明显高于对照组,差异有统计学意义(P<0.05)。结论吉非替尼联合全脑放疗治疗非小细胞肺癌脑转移患者能够明显提高治疗效果,提高患者的生活质量及生存质量,延长生存期,提高生存率,且不良反应较少。

Objective To study the efficacy of Iressa joint whole brain radiation therapy for non-small cell lung cancer （NSCLC） with brain metastases. Methods NSCLC patients with brain metastases were randomly divided into 2 groups,the treat- ment group was given Iressa combined with whole brain radiation therapy, the control group was given only whole brain radiation therapy, check MRI of head, chest CT for curative effect evaluation prior to treatment, after radiation therapy and 3 months after ra- diation therapy, the quality of life score （ KPS）, median survival time, 1-year survival rate, and adverse reactions were compared. Results In the experimental group, the complete remission （CR） was 5 cases, partial response （PR） was 18 cases, stability （SD） was 6 cases, progress （PD） was 1 case, efficient （RR） was 76.7 %, the disease control rates （DCR） was 96.7 %, which were higher than those of the control group （P 〈 0.05 ） ; In the experimental group after treatment, KPS scores was （74.5±7.1 ） points, KPS 10 points was 63.3 %, the median survival time was 12.2 months, 1-year survival rate was 43.3 %, which were signif- icantly higher than those of control group （P 〈 0.05 ） ; Both groups had adverse reactions such as skin rash, nausea, vomiting, diar-rhea, leucopenia, transaminase eleations, and bone marrow suppression;in the experimental group, the incidence of rash was 36.7% ,which was higher than that of the control group, nausea, vomiting（ 16.7% ）, bone marrow suppression accounted for 10.0% , which were lower than the control group（ P 〈 0.05 ） ; 1-month survival in the experimental group was 28 cases, accounting for 93.3% ,3-months survival rate was 76.7% ,6-months survival rate was 66.7%, 1-year survival rate was 50.0% ,which were significantly higher than the control group（P 〈 0.05）. Conclusion Iressa joint whole brain radiation therapy for NSCLC with brain metastases can significantly improve the treatment effect, quality of life and surviVal, prolong survival, increase survival rate, with less adverse reactions.