替莫唑胺联合全脑放疗治疗非小细胞肺癌脑膜转移癌疗效初探

Temozolomide and whole brain radiotherapy for leptomeningeal metastases from non-small cell lung cancer

目的探讨替莫唑胺（TMZ）＋全脑放疗（WBRT）联合治疗非小细胞肺癌（NSCLc）脑膜转移癌（LM）的疗效。方法广东三九脑科医院肿瘤综合治疗中心自2007年10月至2016年6月收治19例NSCLC—LM患者．其中采用TMZ＋WBRT联合治疗者10例，采用其他治疗方式者9例。水研究回颐性分析患者的临床资料和疗效，采用Kaplan-Meier生存分析评价患者的预后。结果治疗后2周TMZ＋WBRT联合治疗组患者中8例缓解，2例稳定，0例进展，缓解率为80．0％。其他治疗方式组患者中5例缓解，3例稳定．1例进展，缓解率为55．6％。TMZ＋WBRT联合治疗组患者的中化生存时间为8个月．6个月生存率为56。3％，1年生存率为33．8％。其他治疗方式组患者的中位生存时间为7个月，6个月生存率为55．6％，1年生存率为14．8％。结论TMZ＋WBRT联合治疗可能延KNSCLC—LM患者的生存时间，改善预后。

Objective To evaluate the clinical efficacy oftemozolomide （TMZ） and whole brain radiotherapy （WBRT） in the treatment of leptomeningeal metastases （LM） from non-small cell lung cancer （NSCLC）. Methods The clinical data were retrospectively analyzed of the 19 patients with LM from NSCLC who had been treated from October 2007 to June 2016 at Guangdong Sanjiu Brain Hospital. Of them, 10 were treated by a combination of TMZ＋WBRT, and 9 by other therapies. The survival rate was determined by the Kaplan-Meier method and analyzed using the log-rank test. Results After treatment for 2 weeks, the illness was alleviated in 8, stable in 2 and progressive in 0 of the 10 patients receiving TMZ＋WBRT, yielding a remission rate of 80%; the illness was alleviated in 5, stable in 3 and progressive in one of the 9 patients receiving other therapies, yielding a remission rate of 55.6%. The median overall survival was 8 months, the survival rate was 56.3% at 6 months and 33.8% at one year for those receiving TMZ＋WBRT; the median overall survival was 7 months, the survival rate was 55.6% at 6 months and 14.8% at one year for those receiving other therapies. Conclusion Temozolomide and whole brain radiotherapy may prolong the survival time and improve the prognosis of patients with LM from NSCLC.