替莫唑胺联合全脑放疗治疗晚期非小细胞肺癌脑膜转移患者的近远期疗效

Short-term and Long-term Efficacy of Temozolomide Combined with Whole Brain Radiotherapy on Treating Patients with Meningeal Metastasis of Advanced Non-small Cell Lung Cancer

目的探讨替莫唑胺联合全脑放疗治疗晚期非小细胞肺癌脑膜转移患者的近远期疗效。方法选取2017年1月至2019年1月辽健集团抚矿总医院接收治疗的72例非小细胞肺癌脑膜转移者作为研究对象,依据治疗方法不同分为两组,对照组患者接受6MV-X全脑放疗,观察组在全脑放疗组基础上使用替莫唑胺口服治疗。参照脑转移实体瘤疗效评价标准(RECIST)对患者的疗效进行评价,评估患者的6个月和12个月生存率,采用KPS评分表评价患者的生命质量,比较两组患者不良反应发生情况。结果观察组患者治疗有效率高于对照组,差异有统计学意义(P<0.05)。观察组患者6个月和12个月生存率明显高于对照组,差异有统计学意义(P<0.05)。观察组患者6个月和12个月生存率明显高于对照组,差异有统计学意义(P<0.05)。两组患者治疗前KPS评分比较差异无统计学意义(P>0.05);治疗后两组KPS评分升高,且观察组高于对照组,差异有统计学意义(P<0.05)。两组患者胃肠道反应、心律失常、嗜睡、血小板减少、白细胞减少、肝酶异常、末梢神经炎发生率比较,差异无统计学意义(P>0.05)。结论使用替莫唑胺联合全脑放疗治疗晚期非小细胞肺癌脑膜转移,能明显延长患者的生存期,提高生命质量,安全性好,近远期疗效可观。

Objective To investigate the short-term and long-term efficacy of temozolomide combined with whole brain radiotherapy in the treatment of patients with meningeal metastasis of advanced non-small cell lung cancer.Methods A total of 72 patients with meningeal metastasis from non-small cell lung cancer admitted to Fumine General Hospital of Liao Jian Group from January 2017 to January 2019 were selected as study subjects,and were divided into 2 groups according to different treatment methods,patients in the control group received 6 MV-X whole-brain radiation therapy,the study group was treated with temozolomide orally on the basis of whole-brain radiotherapy.The efficacy of patients was evaluated according to the therapeutic evaluation criteria for solid tumor with brain metastasis(RECIST),and patients were assessed for 6-month and 12-month survival rate.The Karnofsky(KPS) functional status rating scale was used to evaluate the quality of life of the patients,and the occurrence of toxic and side effects was compared between the 2 groups.Results The total treatment effective rate was higher in the study group than in the control group,the difference was statistically significant(P<0.05).The 6-month and 12-month survival rates were significantly higher in the study group than in the control group,the difference was statistically significant(P<0.05).There was no statistically significant difference in KPS scores between the 2 groups before treatment(P>0.05);KPS score was improved after treatment,and the study group was higher than the control group,the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of gastrointestinal reactions,arrhythmia,drowsiness,thrombocytopenia,leukopenia,abnormal liver enzymes and peripheral neuritis between the 2 groups(P>0.05).Conclusion Temozolomide combined with whole brain radiotherapy for the treatment of advanced NSCLC with meningeal metastasis can significantly prolong the survival time of patients,improve the quality of life,have good safety and achieve considerable short-term and long-term efficacy.