全脑放疗联合榄香烯注射治疗多发脑转移瘤的临床观察

Clinical observation of combined therapy of whole brain radiotherapy and Elemene Injection in the treatment of multiple brain metastases

目的探讨榄香烯注射液联合全脑放疗治疗多发脑转移瘤的效果及不良反应。方法收集南京明基医院2014年4月~2017年4月收治的脑转移瘤行全脑放疗的患者56例,采集患者住院期间的症状变化情况及放疗后的头颅MRI复查数据。根据是否使用榄香烯分为榄香烯组和单放组,对两组患者的肿瘤大小变化、症状改善及毒副作用进行比较。结果榄香烯组的客观缓解率(47.37%)与单放组(44.44%)比较,差异无统计意义(P > 0.05)。与单放组比较,榄香烯组能更好地控制头晕头痛、呕吐、疲乏症状(P < 0.05),不增加神经系统症状控制率和急性放射毒性。在放疗远期反应(放疗结束6个月之后)中,榄香烯组记忆力减退的发生率为21.74%,显著低于单放组的63.64%(P < 0.05)。结论全脑放疗同步榄香烯注射液治疗可增加放疗效果和症状控制率,但不增加客观缓解率。与单独使用放疗比较,其不增加急性放射毒性,能在一定程度上降低晚期毒性。对于一般状况不适合化疗或者抗拒化疗的脑转移患者,可考虑使用榄香烯以配合全脑放疗。

Objective To explore the efficacy and side effects of Elemene Injection combined with whole brain radiotherapy in the treatment of multiple brain metastases. Methods A total of 56 patients with brain metastases treated by whole brain radiotherapy in BenQ Medical Center from April 2014 to April 2017 were collected. The changes of symptoms during hospitalization and the data of brain MRI after radiotherapy were collected. According to whether elemene was used or not, the patients were divided into elemene group and radiotherapy group. The changes of tumor size, symptom improvement and toxicity were compared between the two groups. Results The objective response rate between the elemene group (47.37%) and radiotherapy group (44.44%) had no signficant difference (P > 0.05). Compared with radiotherapy group, elemene group was better in controlling the symptoms of dizziness and headache, vomiting and fatigue (P < 0.05), without increasing the control rate of neurological symptoms and the conditions of acute radiotoxicity. When it came to the long-term radiotherapy response (after 6 months of radiotherapy), the incidence rate of memory loss in the elemene group was 21.74%, which was significantly lower than 63.64% in the radiotherapy group (P < 0.05). Conclusion Whole brain radiotherapy combined with Elemene Injection can increase the effect of radiotherapy and the rate of symptom control. But it can not increase the objective remission rate. Compared with radiotherapy alone, it dosen't increase acute radiotoxicity and can reduce the late toxicity to some extent. Elemene in combination with whole brain radiotherapy may be used in patients with brain metastases who are not suitable for chemotherapy or who are resistant to chemotherapy.