含铂同步化疗与靶向治疗对非小细胞肺癌脑转移患者疗效的比较

Clinical Study of Platinum-Containing Concurrent Chemotherapy and Contrast-targeted Therapy for Non-small Cell Lung Cancer Patients with Brain Metastases

目的探讨含铂同步化疗对比靶向治疗对非小细胞肺癌脑转移患者的临床效果。方法随机选取非小细胞肺癌脑转移患者350例作为研究对象,其中采取含铂同步化疗的患者175例简称对照组,采取靶向治疗的患者175例简称实验组。对含铂同步化疗的患者选用以铂类药物为主,严格根据患者的身体质量规定其所用药剂量,通常采用紫杉醇(Taxol)175 mg/m^2,顺铂(DDP)25 mg/m^2,培美曲塞(Alimta)500 mg/m^2。对进行靶向治疗的患者则采用口服吉非替尼250 mg/d或厄洛替尼150 mg/d治疗,并对比观察两组患者的治疗效果。结果实验组整体疾病控制率为89%,高于对照组(67%);实验组1年生存率为54.7%,略高于对照组(47.3%)。差异无统计学意义(P>0.05);实验组3年生存率为28.9%,高于对照组的7.7%,差异有统计学意义(P<0.05);患者的吸烟状况、病理类型、颅外病灶数目及颅外的病灶近期疗效与患者的生存时间具有相关性。结论与目前常用的标准治疗对于非小细胞肺癌脑转移患者的疗效相比,以厄洛替尼和吉非替尼为代表的靶向治疗药物呈现出了良好的疗效。

Objective To investigate the clinical effect of platinum-based synchronous chemotherapy for patients with brain metastasis of non-small cell lung cancer. Methods 350 patients with brain metastases from non-small cell lung cancer （NSCLC） were enrolled in this study.175 patients treated with platinum-containing concurrent chemotherapy was the control group,175 treated with targeted therapy was the experimental group.Of platinum-containing concurrent chemotherapy in patients with platinum-based drugs,according to the strict requirements define the patient＇s body weight of the dosage,usually with taxol （Taxol 175 mg/m 2,cisplatin （DDP） 25 mg/m 2,pemetrexed （Alimta） 500 mg/m 2.Patients treated with targeted therapy were treated with gefitinib oral 250 mg/d or erlotinib 150 mg/d,and compared the therapeutic effect of the 2 groups of patients. Results The overall disease control rate in the experimental group was 89%,which was higher than that of the control group （67%）.The 1-year survival rate in the experimental group was 54.7%,slightly higher than that of the control group （47.3%）.The difference was not statistically significant （ P 〉0.05）.The 3-year survival rate was 28.9% in the experimental group,7.7% higher than that of the control group （ P 〈0.05）.The smoking status,pathological type,extracranial number of lesions and the short-term efficacy of extracranial lesions have a correlation with the survival time of patients. Conclusion Targeted therapies,such as erlotinib and gefitinib,showed good efficacy compared with the current standard treatment for NSCLC patients with brain metastases.