鞘内注射MTX预防小细胞肺癌脑转移的临床研究

Observation on Preventing Brain Metastase of Small Lung Cancer by Combination Therapy with Intrathecal Chemotherapy

目的 :寻找预防小细胞肺癌 (SCLC)脑转移简单有效的方法。方法 :35例SCLC患者接受常规全身化疗和胸部放疗 ,预防组 2 0例同时联合鞘内化疗 ,MTX 1 0mg m2 ,地塞米松 5mg ,椎管内注射 ,每个化疗周期 1次 ,连用 6次。对照组 1 5例不做鞘内化疗。结果 :脑转移率及 2年生存率预防组为 5 %(1 2 0 )、4 0 % (8 2 0 ) ,对照组为 4 0 % (6 1 5 )、1 3 3% (2 1 5 )。结论

Objective To seek an effective method to prevent cerebral metastases of small lung cancer (SCLC).Method Twenty SCLC patients were treated with systematic chemotherapy and chest radiotherapy combined with intrathecal chemotherapy (IT group),MTX (methotrexate) intrathecally 10 mg/m 2,Dex 5 mg.Fifteen SCLC patients as control group (C group) were given systematic chemotherapy and radiotherapy.Results The 2 year survival rate of the IT group and the brain metastases rate of IT group were 40%(8/20) and 5%(1/20),while those of the C group were 13 3% (3/10) and 40%(6/15).Conclusions The intrathecal chemotherapy is an effective protocol to prevent brain metastasis of small cell lung cancer.This treatment strategy reduces the lifetime risk of brain metastasis and improves the overall survival.