以神经系统症状为首发的肺癌脑转移42例临床治疗体会

42 cases of lung cancer brain metastaseswith first manifestation of neuropsychiatric symptoms

目的探讨以神经系统症状为首发的肺癌的特点及疗效。方法将2007-06—2013-05开封市第二人民医院收治42例以神经系统症状为首发的肺癌脑转移性患者随机分为观察组(n=22)和对照组(n=20),对照组单纯放疗,观察组在放疗治疗前提下加用替莫唑胺;对比2组疗效、不良反应、生存情况。结果观察组总有效率86.36%,完全缓解率40.91%,对照组总有效率65.00%,完全缓解率20.00%;2组患者不良反应及并发症总发生率、0.5a生存率均无明显变化。观察组治疗效果1a、2a生存率(77.27%、59.09%)显著高于对照组(P<0.05)。结论替莫唑胺联合放疗对首发神经系统症状的肺癌脑转移患者优于单纯放疗,不良反应及并发症未增多,可显著提高1a及2a的生存率,值得临床推广。

Objective To investigate the clinical features,therapeutic effects and adverse reactions of the lung cancer brain metastases with first manifestation of neuropsychiatric symptoms.Methods 42 cases of lung cancer brain metastases in our hospital from June 2007 to Mar 2013 were divided into two groups,the observation group(n=22)received temozolomide combined with radiotherapy therapy,the control group(n=20)received radiotherapy treatment only.The efficacy,adverse reaction and survival rates were compared.Results In the observation group,the total effective rate was 86.36%,with 40.91%of complete remission.The total effective rate of the control group was 65%,with 20%of complete remission.The adverse reaction and complications were not different between the two groups.Compared with the control group,there was no significant difference in the incidence of adverse events and complications,0.5 year survival.The 1 year and 2 year survival rate of the observation group was better than that of the control group(P<0.05).Conclusion Temozolomide combined with radiotherapy is better than radiotherapy alone in the treatment of patients with brain metastases of the first neurological symptoms,the adverse reactions and complications are not increased,which can significantly improve the survival rate of 1 and 2 years.It is worthy of clinical promotion.