放化疗同步治疗肺癌脑转移38例临床分析  

Clinical anglysis of concomitant radiotherapy combined with chemotherapy in 38 cases brain metastases of lung cancer

作　　者：陈绍水[1] 宁方玲[1] 赵磊[1] 吕俊华[1] 于泽顺[1] 纪春祥[1] 

机构地区：[1]滨州医学院附属医院肿瘤科,山东滨州256603

出　　处：《肿瘤防治杂志》2005年第19期1502-1504,共3页China Journal of Cancer Prevention and Treatment

摘　　要：目的:观察长春瑞滨(NVB)、顺铂(DDP)加用卫萌(Vm-26)联合脑部放射治疗肺癌脑转移患者的疗效、不良反应和生存率.方法:Vm-26 0.1,静脉滴入,d1～d3;NVB 25 mg/m2,静脉滴入,d1、d8;DDP 20 mg/m2,静脉滴入,d1～d3;21d为1个周期,脑部放疗于第1个周期化疗开始后第5天开始,每次DT1.8～2.0Gy,1次/d,每周5次,1～2个病灶者全脑放疗DT 40 Gy后缩野追加至DT 60 Gy,≥3个转移灶者给予全颅放疗DT45 Gy.结果:治疗后90%患者神经系统症状改善,对脑转移灶的客观有效率为71.1%(27/38),对肺原发灶的有效率为42.1%(16/38),主要不良反应为骨髓抑制和脱发,中位生存期11.01个月,1年生存率39.5%(15/38).结论:同步放、化疗治疗肺癌脑转移患者有效率和生存率均较高,且患者耐受性好.OBJECTIVE： To investigate the therapeutic effect, toxicity, and survival of concurrent radiotherapy combined with NVB, DDP, and Vm-26 in lung cancer patients with brain metastases. METHODS： Vm-26 0. 1 g iv drip d1 -d3 ;NVB 25 mg/m^2 d1 ,d8 iv drip d1,d8;DP 20 mg/m^2 iv drip d1 -d3, every 21 d. Wholebrain radiotherapy （WBRT） was administered on day 5 of the first course of chemotherapy by using ^60Co at a dose of DT1. 8-2. 0 Gy/d given in 5 fractions per week. Patients with 1- 2 brain lesions received WBRT at a dose of DT40 Gy and then small field to a total dose of DT60 Gy. Patients with more than 2 brain lesions of received WBRT at a total dose of DT45 Gy. RESULTS： The treatment improved neurological symptoms in 90% of the patients . The response rates to brain lesions and primary lesions were 71.1% （27/38） and 42.1%（16/38）,respectively. The median survival time （MST） was 11.01 months; the 1-year survival rates was 39.5% （15/38）. The major toxicities were marrow suppression and alopecia. CONCLUSION： Concurrent radio-chemotherapy can be safely preformed for the patients with brain metastases from lung cancer with a remarkable response rate and encouraging survival duration.

关 键 词：肺肿瘤/放射治疗 肺肿瘤/药物治疗 脑肿瘤/放射治疗 脑肿瘤/药物治疗 肿瘤转移/治疗 

分 类 号：R734.2[医药卫生—肿瘤]