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目的探讨吉非替尼联合全脑放疗(WBRT)治疗非小细胞肺癌(NSCLC)脑转移的疗效。方法将53例NSCLC脑转移患者按治疗方法分为两组:试验组35例,吉非替尼联合WBRT治疗;对照组18例,单用WBRT治疗。吉非替尼均采用治疗第1天开始口服,每日250 mg,直到病变进展或其他原因停药。WBRT均从治疗第1天开始,单次周边剂量2 Gy,治疗总剂量为40 Gy,治疗次数20次,5次/周。于治疗前后对比两组间的治疗效果以及不良反应。结果试验组35例患者中,PR 21例,PD 1例,RR 77.2%,DCR 97.2%,中位生存期12.1个月,1年生存率68.6%;对照组PR 5例,PD 5例,RR 38.9%,DCR 72.2%,中位生存期9.8个月,1年生存率27.8%;吉非替尼联合WBRT组在近期疗效(RR及DCR)及远期疗效(1年生存率)方面均高于单纯WBRT组(P=0.014,0.016,0.000)。结论吉非替尼联合WBRT治疗NSCLC脑转移具有较好的近期及远期疗效。
Objective To investigate the effect of gefitinib combined with whole brain irradiation (WBRT) on brain metastases of non-small cell lung cancer (NSCLC). Methods Fifty-three NSCLC patients with brain metastases were divided into two groups according to the treatment methods: 35 in trial group and gefitinib combined with WBRT; 18 in control group, treated with WBRT alone. Gefitinib is started on the first day of treatment orally, 250 mg daily until the lesion progresses or for other reasons. WBRT from the first day of treatment, a single peripheral dose of 2 Gy, the total dose of 40 Gy, the number of 20 times, 5 times / week. Before and after treatment compared the two groups of treatment and adverse reactions. Results In the 35 patients in the experimental group, there were 21 cases of PR, 1 case of PD, 77.2% of RR and 97.2% of DCR. The median survival time was 12.1 months and the 1-year survival rate was 68.6%. In the control group, 5 cases were PR, 5 cases were PD, 38.9%, DCR 72.2%, median survival 9.8 months, and 1-year survival rate 27.8%. Gefitinib combined with WBRT group were both high in short-term efficacy (RR and DCR) and long-term efficacy In the simple WBRT group (P = 0.014, 0.016, 0.000). Conclusion Gefitinib combined with WBRT has good short-term and long-term therapeutic effects on brain metastases of NSCLC.