手术联合放疗配合阿美替尼靶向治疗肺癌脑转移患者的疗效及对其神经认知功能的影响

Effect of surgery combined with radiotherapy and ametinib in the treatment of lung cancer patients with brain metastases and its influence on neurocognitive function

目的分析手术联合放疗配合阿美替尼靶向治疗肺癌脑转移患者的疗效及对其神经认知功能的影响。方法选择2022年2月至2023年2月渭南市中心医院行放疗配合阿美替尼靶向治疗的肺癌脑转移患者40例纳入对照组,另选取同期行手术联合放疗配合阿美替尼靶向治疗的肺癌脑转移患者40例纳入联合组。比较两组患者治疗效果、生活质量、神经认知功能、生存情况、不良反应发生情况。结果联合组治疗3个月后的36条目简明健康量表(SF-36)评分及简明精神状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)评分均高于对照组(P<0.05)。中位无进展生存期(PFS)及总生存期(OS)均长于对照组,1年生存率高于对照组,消化道反应、骨髓抑制、肝功能损伤、皮疹脱屑、脱发等并发症发生率及复发率均低于对照组(P<0.05)。结论手术联合放疗配合阿美替尼靶向治疗肺癌脑转移患者有助于提高患者生活质量及神经认知功能,延长患者生存期限,疗效显著,安全性高。

Objective To analyze the efficacy of surgery combined with radiotherapy and ametinib in the treatment of lung cancer patients with brain metastases and its influence on their neurocognitive function.Methods Forty patients with lung cancer brain metastases who were admitted to Weinan Central Hospital from February 2022 to February 2023 for radiotherapy combined with ametinib targeted therapy were included in the control group,and 40 patients with lung cancer brain metastases who received surgery combined with radiotherapy and ametinib targeted therapy during the same period were included in the combination group.The treatment effect,quality of life,neurocognitive function,survival and adverse reactions were compared between the two groups.Results After 3 months of treatment,the scores of the 36-item Compact Health Scale(SF-36),Compact Mental State Scale(MMSE)and Montreal Cognitive Assessment Scale(MoCA)in the combination group were higher than those in the control group(P<0.05).The median progress-free survival(PFS)and overall survival(OS)of the combination group were longer than those of the control group;The 1-year survival rate was higher than that of the control group,and the incidence and recurrence of complications such as digestive tract reaction,bone marrow suppression,liver function injury,rash desquamation and alopecia were lower than those of the control group(P<0.05).Conclusions Surgery combined with radiotherapy and ametinib in the targeted treatment of lung cancer patients with brain metastases can improve the quality of life and neurocognitive function,and prolong the survival period of patients,with significant efficacy and high safety.