靶向药物治疗肺癌脑转移的效果

Effect of targeted drugs on brain metastasis of lung cancer

目的探讨靶向药物治疗肺癌脑转移的效果。方法将2015年1月至2019年1月在我院肿瘤科治疗的84例EGFR基因突变的肺癌脑转移患者随机分为两组,对照组使用全脑放疗治疗,在此基础上,观察组联合靶向药物吉非替尼治疗,比较两组的近期疗效、不良反应、生存情况、血清因子水平变化。结果观察组总体及脑转移灶的治疗有效率、疾病控制率均明显高于对照组,差异有统计学意义(P<0.05);观察组骨髓抑制、消化道反应发生率低于对照组,而皮疹脱屑发生率高于对照组,差异有统计学意义(P<0.05),两组放射性颅内高压、肝功能损伤不良反应发生率比较,差异无统计学意义(P>0.05);观察组无疾病进展生存期、总生存期明显长于对照组,1年生存率高于对照组,而远处转移率、局部复发率明显低于对照组,差异有统计学意义(P<0.05);观察组治疗后MMP-2、MMP-9水平明显低于对照组,差异有统计学意义(P<0.05)。结论靶向药物治疗肺癌脑转移的近期效果良好,能增强放疗敏感性,提升杀灭肿瘤效果,从而延长生存时间,抑制肿瘤的复发及转移,且不增加不良反应,具有积极的临床意义。

Objective To explore the effect of targeted drugs on brain metastasis of lung cancer.Methods From January 2015 to January 2019,84 patients with brain metastasis of lung cancer with EGFR gene mutation were randomly divided into two groups.The control group was treated with whole brain radiotherapy.On this basis,the observation group was treated with gefitinib.The short-term curative effect,adverse reactions,survival conditions and changes of serum factors were compared between the two groups.Results The effective rate and the disease control rate in the observation group were significantly higher than those in the control group,with significant difference(P<0.05).The incidences of bone marrow suppression and digestive tract reaction in the observation group were lower than those in the control group,but the incidences of skin rash and desquamation were higher than those in the control group,with significant difference(P<0.05).There was no significant difference in the incidence of adverse reactions such as radiation intracranial hypertension and liver function injury between the two groups(P>0.05).The disease-free survival time,overall survival time and 1-year survival rate in the observation group were significantly longer than those in the control group,while the distant metastasis rate and local recurrence rate in the observation group were significantly lower than those in the control group,with significant difference(P<0.05).The levels of MMP-2 and MMP-9 in the observation group were significantly lower than those in the control group after treatment,with significant difference(P<0.05).Conclusion Targeted drugs have a good short-term effect in the treatment of brain metastasis of lung cancer,which can enhance the sensitivity of radiotherapy and enhance the effect of killing tumor,thus prolonging the survival time and inhibiting the recurrence and metastasis of tumor,without increasing adverse reactions.Thus,it has positive clinical significance.