分次立体定向放疗同步化疗联合贝伐珠单抗治疗肺癌脑转移的疗效及安全性

Efficacy and safety of fractionated stereotactic radiotherapy concurrent chemotherapy combined with bevacizumab in the treatment of brain metastasis of lung cancer

目的探讨分次立体定向放疗同步化疗联合贝伐珠单抗治疗非小细胞肺癌脑转移患者的疗效及安全性。方法选取45例非小细胞肺癌脑转移的患者进行回顾性研究,根据治疗方法的不同分为观察组(n=22)和对照组(n=23)。两组均采用分次立体定向放疗同步化疗,观察组在此基础上联合贝伐珠单抗。比较两组的客观缓解率(ORR)、疾病控制有效率(DCR)、颅内高压缓解率、卡氏评分(KPS)改善情况、1年复发率和颅内疾病无进展生存时间(iPFS),记录两组的不良反应。结果观察组的ORR为59.09%,高于对照组的26.09%(P<0.05);两组的DCR分别为86.36%和69.57%(P>0.05)。观察组的颅内高压缓解率为59.09%,高于对照组的21.74%(P<0.05)。观察组的KPS评分上升率为68.18%,较对照组的39.13%有改善趋势(P=0.05)。观察组的1年复发率为40.91%,低于对照组的73.91%(P<0.05);观察组的iPFS为17.22个月,长于对照组的10.30个月(P<0.05)。两组不良反应相近(P>0.05)。结论在非小细胞肺癌脑转移患者中,分次立体定向放疗同步化疗联合贝伐珠单抗能提高ORR,改善颅内高压症状和生存质量,降低1年复发率和延长颅内无疾病进展时间,具有肯定的临床疗效和良好的安全性。

Objective To evaluate the efficacy and safety of fractionated stereotactic radiotherapy concurrent chemotherapy combined with bevacizumab in the treatment of patients with brain metastasis of non-small cell lung cancer.Methods Totally 45 patients with brain metastasis of non-small cell lung cancer were selected for a retrospective study.According to the different treatment methods,they were divided into a observation group(n=22)and a control group(n=23).Both groups were treated with fractionated stereotactic radiotherapy concurrent chemotherapy,and the observation group was also combined with bevacizumab.The objective response rate(ORR),disease control rate(DCR),remission rate of intracranial hypertension,improvement rate of Karnofsky score (KPS), 1-year recurrence rate and intracranial progression-free survival time (iPFS) were compared between the two groups. Results The ORR of the observation group was 59.09%, which was higher than that of the control group (26.09%, P < 0.05), and the DCR of the two groups was 86.36% and 69.57% respectively (P > 0.05). The remission rate of intracranial hypertension in the observation group was 59.09%, which was higher than that of the control group (21.74%, P < 0.05). The rising rate of KPS score in the observation group was 68.18%, which was better than that in the control group (39.13%, P = 0.05). The 1-year recurrence rate of the observation group was 40.91%, which was lower than that of the control group (73.91%, P < 0.05), and the iPFS of the observation group was 17.22 months, which was longer than that of the control group (10.30 months, P < 0.05). The adverse reactions of the two groups were similar (P > 0.05). Conclusion In patients with brain metastasis of non-small cell lung cancer, fractionated stereotactic radiotherapy concurrent chemotherapy combined with bevacizumab can increase the objective response rate, improve the symptoms of intracranial hypertension and life of quality, decrease the 1-year recurrence rate and prolong intracranial progression-free survival time, with definite clinical efficacy and good safety.