A Phase Ⅰ trial of dose escalation of topotecan combined with whole brain radiotherapy for brain metastasis in lung cancer

Objective The aim of this study was to define the maximum-tolerated dose (MTD) and observe the toxicity of escalating topotecan combined whole brain radiotherapy for brain metastasis in lung cancer.

Brain metastasis in non-small cell lung cancer (NSCLC) patients with uncommon EGFR mutations： a report of seven cases and literature review

Brain metastasis(BM)arising from non-small cell lung cancer(NSCLC)with rare epidermal growth factor receptor(EGFR)mutations is quite rare.The prognosis and therapeutic effects of BM remain enigmatic.To the best of our knowledge,this is the first report to make a separate analysis of BM from NSCLC patients with original uncommon EGFR mutations.We retrospectively reviewed 7 cases of BM arising from 42 cases of uncommon EGFR mutated lung cancer in Tianjin Medical University Cancer Institute and Hospital.We also performed a literature review to assess therapeutic features and outcomes.

Relationship between HER-2 overexpression and brain metastasis in esophageal cancer patients

AIM:To study if HER-2 overexpression by locally advanced esophageal cancers increase the chance of brain metastasis following esophagectomy.METHODS:We retrospectively reviewed the medical records of esophageal cancer patients who underwent esophagectomy at University of Iowa Hospitals and Clinics between 2000 and 2010.Data analyzed consisted of demographic and clinical variables.The brain metastasis tissue was assayed for HER-2 overexpression utilizing the FDA approved DAKO Hercept Test.RESULTS:One hundred and forty two patients were reviewed.Median age was 64 years(36-86 years).Eighty eight patients(62%) received neoadjuvant chemoradiotherapy.Pathological complete and partial responses were achieved in 17(19%) and 71(81%) patients.Cancer relapsed in 43/142(30%) patients.The brain was the first site of relapse in 9/43 patients(21%,95% CI:10%-36%).HER-2 immunohistochemistry testing of the brain metastasis tissue showed that 5/9(56%) cases overexpressed HER-2(3+ staining).CONCLUSION:HER-2 overexpression might be associated with increased risk of brain metastasis in esophageal cancer patients following esophagectomy.Further studies will be required to validate this observation.

Prognostic factors affecting long-term outcomes in patients with brain metastasis from esophageal carcinoma

Objective: The incidence of brain metastasis from esophageal cancer(BMEC) has increased in recent years.Thus, it is necessary to identify factors that affect long-term outcomes for such patients.Methods: From January 1997 to July 2018, consecutive patients(10,043 patients, 31 with brain metastasis) with esophageal cancer(EC) treated at Zhejiang Cancer Hospital were recruited for retrospective analysis.Demographic, clinical, and pathological variables and the survival data were retrieved.Results: The median time from diagnosis of EC to diagnosis of brain metastases was 7.67(range, 0.43-55.20)months. The median survival time of BMEC patients from diagnosis of primary esophageal tumor was 16.7(range,2.33-163.30) months and the median survival time from the point of diagnosis of brain metastasis was 6.47(range,0.43-148.13) months. Univariate and multivariate analyses showed that the pathology type, EC without chemotherapy, and bone metastasis history were significantly associated with a shorter time interval between the first treatment of EC and brain metastasis. Chemotherapy history after brain metastasis, whole brain radiation therapy(WBRT) history, and surgery were significant predictors for better long-term survival outcomes.Conclusions: Our findings indicate that the use of surgery, WBRT, and chemotherapy can achieve the best therapeutic effects for BMEC patients.

Therapy for non-small-cell lung cancer patients with brain metastasis

Brain metastasis is a major cause of poor prognosis and high mortality for non-small cell lung cancer patients. The prognosis of non-small-cell lung cancer(NSCLC) patients with brain metastasis is generally poor and more effective treatment is required to improve their prognosis. Whole-brain radiotherapy, surgery, stereotactic radiosurgery, chemotherapy and targeted therapy are the main treatment for brain metastasis. This review focuses on the five therapeutic strategy and in particular, on targeted therapy.

Updates in the management of brain(leptomeningeal) metastasis of lung cancer

Brain(leptomeningeal) metastasis is one of the most common and severe complications of lung cancer. This article interprets expert consensus on the treatment advice for brain(leptomeningeal) metastasis of lung cancer, expounding on its epidemiology, diagnostic standards, efficacy assessment, treatment advice, and other aspects.

Chemotherapy combined with bevacizumab for small cell lung cancer with brain metastases:A case report

BACKGROUND Small cell lung cancer(SCLC)is a common and aggressive subtype of lung cancer.It is characterized by rapid growth and a high mortality rate.Approximately 10%of patients with SCLC present with brain metastases at the time of diagnosis,which is associated with a median survival of 5 mo.This study aimed to summarize the effect of bevacizumab on the progression-free survival(PFS)and overall survival of patients with brain metastasis of SCLC.CASE SUMMARY A 62-year-old man was referred to our hospital in February 2023 because of dizziness and numbness of the right lower extremity without headache or fever for more than four weeks.The patient was diagnosed with limited-stage SCLC.He received 8 cycles of chemotherapy combined with maintenance bevacizumab therapy and achieved a PFS of over 7 mo.CONCLUSION The combination of bevacizumab and irinotecan effectively alleviated brain metastasis in SCLC and prolonged PFS.

Radiotherapy for multiple brain metastases from hepatocellular carcinomas

A 78-year-old man with liver cirrhosis was found to have multiple hepatocellular carcinomas （HCCs） and underwent 3 sessions of transcatheter arterial chernoernbolization. Fourteen months after diagnosis, the patient presented with left herniparesis. Contrast- enhanced magnetic resonance imaging showed multiple metastases with ring-shaped enhancement in the cerebrum and cerebellum. There were no metastases to other organs. The metastatic lesions almost completely disappeared after whole-brain radiotherapy with a total dose of 50 Gy. Neurologic symptoms decreased, and the patient＇s quality of life improved. The patient underwent 2 more sessions of transcatheter arterial chemoembolization. Twelve months after the diagnosis of brain metastasis, the patient remains alive. The present case indicates that radiotherapy can improve quality of life and prolong survival in some patients with brain metastases from HCCs.

The effects of three-dimensional conformal radiotherapy combined with whole brain irradiation on brain metastases

Objective： To observe the recently therapeutic effects and toxicity of three-dimensional conformal radiotherapy combined with whole brain irradiation for patients with brain metastasis. Methods： 33 cases were treated by whole brain irradiation at first, the dose of which was 36-40 Gy （18-20 f）. Then three-dimensional conformal radiotherapy was added to the focus with a total dose of 20-25 Gy, whose fractionated dose was 2-5 Gy/time, 5 times/week or 3 times/week. Results： Within 1 month after radiotherapy, according to imaging of the brain, the CR of all patients was 45.5%, PR 36.4%, NC 15.1%, and PD 3%. For the 32 cases with neural symptoms before radiation, the CR of the symptoms was 40.6% and PR 59.4%. All patients gained different increases in KPS grade. By the end of the follow-up period, there were 22 deaths with the mean survival time up to 9.3 months. Conclusion： Three-dimensional conformal radiotherapy combined with whole brain irradiation can not only effectively control brain metastases and improve life quality, but also tends to prolong survival time.

重组人血管内皮抑制素联合脑部放疗与单纯脑部放疗治疗实体肿瘤脑转移的疗效及预后

目的探究重组人血管内皮抑制素(rh-Endostatin)联合脑部放疗(WBRT)与单纯WBRT治疗实体肿瘤脑转移的疗效及预后。方法回顾性分析2020-03—2022-11于资阳市人民医院肿瘤科治疗的94例患者的临床资料,根据治疗方式分为试验组和对照组,采用WBRT治疗的46例患者纳入对照组,采用rh-Endostatin联合WBRT治疗的48例患者纳入试验组,治疗结束1个月后比较临床疗效及肿瘤标志物指标[癌胚抗原(CEA)、癌抗原(CA125)、糖类抗原(CA19-9)、血管内皮生长因子(VEGFA、VEGFB、VEGFC)]、免疫功能(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、脑水肿体积和脑血流动力学参数(大脑前动脉平均血流速度和搏动指数)、生存质量[欧洲癌症研究治疗组织生命质量测定量表(EORTCQLQ)]、神经认知水平[简易精神状态量表(MMSE)],比较2组患者治疗期间放射性损伤,通过制作生存曲线分析患者预后情况。结果试验组患者治疗结束1个月时临床总有效率高于对照组(47.92%比26.09%),差异有统计学意义(P<0.05);2组患者治疗结束1个月时肿瘤标志物CEA、CA125、CA19-9、VEGFA、VEGFB、VEGFC水平,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平,脑水肿体积、搏动指数均较治疗前显著降低(P<0.05),试验组患者肿瘤标志物水平和脑水肿体积显著低于对照组患者(18.76±2.54比20.78±3.12,26.78±4.98比33.12±5.19,31.34±3.12比37.24±3.98,90.76±16.97比121.78±18.12,83.78±11.02比105.23±12.19,65.34±9.12比83.23±10.98,144.58±71.55比203.87±70.59),CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平显著升高(59.67±4.33比55.41±4.02,31.22±3.34比27.74±3.79,1.17±0.22比0.96±0.15),差异均有统计学意义(P<0.05);2组患者CD8^(+)水平、大脑前动脉平均血流速度、EORTC各维度评分和MMSE评分相较治疗前均明显升高(P<0.05),试验组患者CD8^(+)水平明显低于对照组(27.02±3.08比28.92±3.31),大脑前动脉平均血流速度(56.67±3.33比55.01±2.06)、EORTC各维度评分和MMSE评分(26.58±1.11比25.87±1.17)明显高于对照组,差异均有统计学意义(P<0.05);2组患者治疗期间均发生轻微放射性损伤,差异无统计学意义(P>0.05);治疗后试验组患者中位总生存期(OS)和颅内疾病无进展期(iPFS)均明显长于对照组患者(9.5比7.5,8.0比6.0),差异有统计学意义(P<0.05)。结论rh-Endostatin联合WBRT治疗实体肿瘤脑转移患者可有效改善近期疗效,抑制肿瘤进展,改善脑血流,维持认知功能及生存质量,保护免疫功能。该方案安全性良好,可一定程度上延长患者的OS和iPFS。

基于脑MRI的机器学习预测非小细胞肺癌T790M突变

目的:本研究基于脑部T_(1)C和T_(2)W MRI建立人工智能模型,预测肺癌脑转移患者在靶向治疗中的耐药性T790M突变。方法:本研究收集80例肺癌脑转移患者(2017年6月—2019年12月)的T_(1)C和T_(2)W MRI影像和临床数据进行回顾性分析(患者按照2∶1的比例分成训练集和测试集)。采用无监督k-means算法将肿瘤区域划分为高亮度区域和低亮度区域,提取不同区域的影像组学图像特征构建模型,评估每个模型的诊断效果。绘制受试者工作特征(Receiver operating characteristic,ROC)曲线,计算ROC曲线下面积(Area under curve,AUC)、特异性和敏感性作为模型评价指标,分析模型的潜在临床应用价值。结果:对T_(1)C和T_(2)W MRI和临床特征融合的统计计算表明,本研究建立的模型对T790M突变具有良好的预测能力,在训练集和测试集上的AUC分别为0.899和0.818。结论:本研究建立的计算机模型可以有效预测肺癌脑转移患者T790M突变,具有潜在的临床辅助诊断价值。

伽玛刀立体定向放射治疗肺癌脑转移瘤患者预后不良的影响因素

目的:分析伽玛刀立体定向放射治疗肺癌脑转移瘤患者预后不良的影响因素。方法:回顾性分析2022年1月至2023年1月在该院接受伽马刀立体定向放射治疗的121例肺癌脑转移瘤患者的临床资料。统计伽玛刀立体定向放射治疗肺癌脑转移瘤患者的预后情况,采用Logistic回归分析伽玛刀立体定向放射治疗肺癌脑转移瘤患者预后不良的影响因素。结果:121例伽马刀立体定向放射治疗肺癌脑转移瘤患者预后不良40例,设为预后不良组,预后良好81例,设为预后良好组;预后不良组脑转移瘤最大直径≥3 cm、血清鳞状细胞癌抗原(SCC-Ag)≥3.80 ng/mL、血清细胞角蛋白19片段(CYFRA21-1)≥7.52 ng/mL、血清神经元特异性烯醇化酶(NSE)≥50.81μg/L占比均高于预后良好组,差异有统计学意义(P<0.05);Logistic回归分析结果显示,血清SCC-Ag≥3.80 ng/mL、血清NSE≥50.81μg/L均为伽玛刀立体定向放射治疗肺癌脑转移瘤患者预后不良的危险因素(OR>1,P<0.05)。结论:血清SCC-Ag≥3.80 ng/mL、血清NSE≥50.81μg/L均为伽玛刀立体定向放射治疗肺癌脑转移瘤患者预后不良的危险因素。

艾迪注射液联合常规化疗对肺癌脑转移患者的临床疗效

目的观察艾迪注射液联合化疗对肺癌脑转移患者认知障碍的缓解情况。方法回顾性分析2018年6月至2020年6月在浙江省丽水市人民医院就诊的80例肺癌脑转移患者的临床资料,按照不同治疗方法分为常规化疗组和艾迪组,常规化疗组患者采用顺铂联合多西他赛的化疗方案,艾迪组在常规化疗组基础上予以艾迪注射液。观察2组患者的近期疗效、认知功能以及毒副作用,评价联合艾迪注射液治疗的有效性和安全性。结果常规化疗组患者近期有效率50%,艾迪组患者近期有效率73%,2组差异有统计学意义(χ^(2)=4.266,P=0.039)。治疗开始前,常规化疗组和艾迪组患者的蒙特利尔认知评估量表(MoCA)评分和简易智能量表(MMSE)评分差异无统计学意义。治疗后2周,与常规化疗组比较,艾迪组患者的MoCA评分和MMSE评分均增加,差异具有统计学意义(t=-3.462、-2.507,P=0.001、0.047);治疗后2周艾迪组患者的Karnofsky评分和生活质量量表(QOL)评分升高,差异具有统计学意义(t=-4.634、-4.050,P<0.01)。与常规化疗组比较,艾迪组患者骨髓抑制和眩晕情况减轻,差异具有统计学意义(χ^(2)=4.126、4.050,P=0.042、0.044),恶心呕吐等胃肠道反应和脱发情况差异无统计学意义(P>0.05)。80例患者均因本病死亡。常规化疗组患者平均生存期为(15±3)个月,艾迪组患者的中位生存期为(18±4)个月,2组差异无统计学意义(χ^(2)=17.752,P<0.01)。结论艾迪注射液联合常规化疗方案治疗肺癌脑转移患者可提升近期疗效,缓解认知障碍,减轻化疗的毒副作用,但对于患者的生存期无明显影响。

全乳切除术后放射治疗对前哨淋巴结微转移早期乳腺癌患者预后影响的Meta分析

目的:荟萃文献,对比分析前哨淋巴结微转移早期乳腺癌患者全乳切除术后行与未行放射治疗的预后。方法:检索中国生物医学文献数据库(China Biology Medicine,CBM)、中国期刊全文数据库(China National Knowledge Infrastructure,CNKI)、维普(VIP)、万方数据库、PubMed数据库、Embase数据库、Web of science(WOS)数据库、Cochrane数据库,由2名研究者各自独立对入选研究的有关试验设计、研究对象特征、研究结果等进行摘录,采用纽卡斯尔渥太华量表进行质量评价,采用Stata 17.0及Review Manager 5.4进行Meta分析。结果:最终筛选出9篇相关文献,均为回顾性研究。中位随访30~98个月。术后放射治疗组与非放射治疗组乳腺癌特异性生存期(breast cancer-specific survival,BCSS)差异无统计学意义(HR=1.18,95%CI:0.94~1.48,Z=1.43,P=0.15);两组无病生存期(disease-free survival,DFS)差异亦无统计学意义(HR=0.51,95%CI:0.07~3.62,Z=-0.668,P=0.50);两组总生存期(overall survival,OS)差异亦无统计学意义(HR=1.02,95%CI:0.93~1.12,Z=0.39,P=0.70)。结论:前哨淋巴结微转移早期乳腺癌患者(T0、T1~2NmiM0)全乳切除术后予以放射治疗并不能改善患者的BCSS、DFS、OS。

不同剂量脑立体定向放疗联合PD-1/PD-L1抑制剂治疗非小细胞肺癌脑转移的疗效及安全性

目的不同剂量脑立体定向放疗联合PD-1/PD-L1抑制剂治疗非小细胞肺癌脑转移的疗效及安全性。方法选取50例非小细胞肺癌脑转移患者作为研究对象,根据患者脑立体定向放疗分割剂量分为A组(n=15)、B组(n=15)和C组(n=20),患者均接受脑立体定向放疗联合生存PD-1/PD-L1抑制剂治疗,A组脑立体定向放疗剂量为4 Gy/f,12 f,B组为5 Gy/f,8 f组,C组为7 Gy/f,5 f。对比三组患者治疗后临床疗效、不良反应发生率以及生存情况;对比三组患者治疗前后KPS评分。结果三组患者临床总有效率比较差异具有统计学意义(P<0.05);C组临床总有效率比较显著高于A组和B组(P<0.05);三组患者不良反应总发生率对比差异无统计学意义(P>0.05);A组、B组和C组患者中位生存期分别为2.70个月、2.40个月和6.60个月。Log-rank检验结果提示,三组患者中位生存期比较,差异具有统计学意义(P<0.05);治疗后,三组患者的KPS评分均显著升高,组间比较差异显著,且C组患者较A组和B组显著更高(P<0.05)。结论对于非小细胞肺癌脑转移患者,7 Gy/f,5 f分割剂量相比于4 Gy/f,12 f和5 Gy/f,8 f联合PD-1/PD-L1抑制剂改善患者的临床疗效更明显,延长生存时间和生存质量更为明显。

27例卵巢上皮性癌脑转移患者临床特征分析

【目的】探讨卵巢上皮性癌(EOC)脑转移患者的特点及预后。【方法】回顾性分析2010年1月至2019年12月湖南省肿瘤医院诊治的27例EOC脑转移患者的临床病理学特点、治疗模式及预后。【结果】本研究共纳入27例患者,中位生存时间15个月。体力状况(PS)评分、脑外转移、铂敏感性、初诊国际妇产科联盟(FIGO)分期和治疗模式与患者生存期相关。【结论】EOC脑转移患者预后差,相比单一治疗模式,对这类患者采用多种治疗模式有利于改善预后。

ITGA6基因对非小细胞肺癌脑转移瘤细胞的影响

目的深入探究ITGA6基因在非小细胞肺癌(non-small cell lung cancer,NSCLC)脑转移瘤细胞增殖、细胞周期调控、侵袭及迁移过程中的具体作用机制。方法通过挖掘GEO数据库中的NSCLC脑转移瘤相关数据,本研究成功识别出ITGA6基因为与NSCLC脑转移瘤发生和发展相关的重要因子。在此基础上,进一步探究该基因表达水平与NSCLC脑转移瘤患者预后之间的关联性。为验证ITGA6在NSCLC脑转移瘤中的表达模式,本研究进一步采用实时定量逆转录PCR(qRT-PCR)和Western Blot实验技术,在NSCLC脑转移瘤细胞系测定ITGA6表达水平。利用基因转染技术,在体外NSCLC脑转移瘤细胞系H1915-BrM和A549-BrM中分别转染阴性对照(NC组)和ITGA6特异性沉默载体(si-ITGA6组)。通过CCK-8增殖实验评估细胞增殖能力;利用EDU实验进一步验证细胞增殖变化;应用流式细胞技术检测细胞周期分布情况;通过Transwell侵袭实验和划痕愈合实验分析细胞侵袭和迁移能力。利用Western Blot技术检测上皮-间质转化(epithelial-mesenchymal transition,EMT)相关蛋白的表达水平。结果利用GEO数据库系统分析NSCLC脑转移瘤的差异表达基因,并发现ITGA6是其中一个关键的上调基因。临床数据分析表明:ITGA6高表达与NSCLC脑转移瘤患者不良预后显著相关(P<0.05)。进一步通过qRT-PCR和Western Blot技术在实验层面验证ITGA6在肺癌脑转移瘤细胞系中高表达。CCK-8和EDU实验结果表明:si-ITGA6显著抑制NSCLC脑转移瘤细胞H1915-BrM和A549-BrM的增殖(P<0.05)。流式细胞技术揭示:si-ITGA6处理后,细胞在G0/G1期比例增加,并且S期及G2期细胞随之减少,表明细胞周期被阻滞(P<0.05)。Transwell和划痕实验均显示,si-ITGA6显著降低NSCLC脑转移瘤细胞侵袭和迁移能力。Western Blot观察分析:si-ITGA6组中上皮标记物E钙黏蛋白表达显著上升,而间质标记物纤连蛋白、波形蛋白以及基质金属蛋白酶(MMP-2和MMP-9)表达则显著下降,提示EMT过程受到抑制。结论通过特异性沉默ITGA6基因,能够显著抑制NSCLC脑转移瘤细胞增殖、迁移和侵袭能力,同时阻滞细胞周期,并调控EMT相关蛋白的表达。

功能神经导航联合术中荧光素钠显像辅助切除脑转移瘤的临床研究

目的研究功能神经导航联合术中荧光素钠显像在脑转移瘤手术的应用。方法回顾性分析40例脑转移瘤病例资料,按术中是否使用荧光素钠分为观察组(n=20)和对照组(n=20),术前均完善头部CT、MRI平扫与增强、磁共振血管造影(magnetic resonance angiography,MRA)、磁共振静脉成像(magnetic resonance venography,MRV)、磁共振弥散加权成像(diffusion-weighted imaging,DWI)、磁共振弥散张量成像(diffusion tensor imaging,DTI)等,将术前影像资料导入功能神经系统导航软件,确定肿瘤位置及与重要神经纤维传导束、锥体束、大血管的空间关系,再与头颅多平面CT进行图像融合确定手术导航计划。术前对患者进行荧光素钠过敏试验后,静脉注射小剂量荧光素钠(2mg/kg)。术中将神经导航与荧光素钠联合使用,观察肿瘤与正常脑组织边界进行切除。结果在肿瘤切除与术后Karnofsky功能状态评分(Karnofsky performance status scale,KPS)改善情况,观察组优于对照组,差异具有统计学意义(χ^(2)=6.144,P=0.013;χ^(2)=4.286,P=0.038)。观察组术后新发功能障碍较对照组减少,差异有统计学意义(χ^(2)=4.800,P=0.029)。术后并发症、手术时间与住院时间两组差异无统计学意义(χ^(2)=2.294,P=0.130;t=0.589,P=0.560;t=1.065,P=0.294)。结论功能神经导航联合术中荧光素钠显像在脑转移瘤手术可准确定位肿瘤与正常脑组织边界关系,提高肿瘤切除率,改善患者生活质量与预后。

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

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。

帕博利珠单抗治疗驱动基因阴性的非小细胞肺癌脑转移患者的效果

目的探讨帕博利珠单抗治疗驱动基因阴性的非小细胞肺癌脑转移患者的效果。方法选取140例驱动基因阴性的非小细胞肺癌脑转移患者作为研究对象,随机分为研究组与对照组,各70例。对照组患者单纯行脑部放射治疗(立体定向放射治疗/全脑放射治疗),研究组患者在脑部放射治疗的基础上联合应用帕博利珠单抗治疗。比较两组患者临床疗效、无进展生存期、总生存期及不良反应发生情况。结果研究组患者临床疗效优于对照组,缓解率及控制率高于对照组,无进展生存期及总生存期长于对照组,食欲减退发生率低于对照组,皮疹/瘙痒、中性粒细胞减少发生率高于对照组(P<0.05)。结论在放射治疗的基础上联合应用帕博利珠单抗治疗驱动基因阴性的非小细胞肺癌脑转移患者能够提高治疗效果,延长患者生存期,且安全性较高。