尼莫司汀配合全脑放疗治疗35例肺癌多发性脑转移的临床观察  

Clincal Observation of ACNU Combined with Whole Brain Radiotherapy for Brain Metastases from Lung Cancer

作　　者：何汉平[1] 郭友全[1] 黎艳萍[1] 臧爱华[1] 

机构地区：[1]湖北省肿瘤医院放疗科,湖北武汉430079

出　　处：《中国神经肿瘤杂志》2009年第1期58-61,共4页Chinese Journal of Neuro-Oncology

摘　　要：背景与目的:肺癌脑转移的临床预后较差,本研究观察尼莫司汀配合放疗治疗肺癌多发性脑转移的疗效及不良反应。方法:35例肺癌多发脑转移患者,放疗后使用尼莫司汀单药化疗。全脑放疗为DT1.8～2Gy/次,5次/周,总剂量36～40Gy。尼莫司汀化疗平均剂量125mg/次,每4～6周重复,所有患者使用2～3次。治疗期间注意血常规及肝肾功能变化情况,并给予脱水、支持对症治疗。在放疗结束后3个月复查脑MRI,观察肿瘤大小,并统计1年生存情况。结果:所有病例在治疗期间无颅内、外病灶进展病例,28例伴有神经症状者均得到缓解。放疗结束后3个月单纯颅内病灶评价:其中CR5例,PR26例,SD4例,PD0例。颅内病灶有效率(CR+PR)为88.6%(31/35)。一年生存率为45.7%(16/35),中位生存期9.3个月。不良反应主要是脑充血水肿以及尼莫司汀化疗反应,多为Ⅰ、Ⅱ度,无Ⅳ度不良反应。结论:尼莫司汀配合放疗治疗肺癌多发性脑转移的疗效好,不良反应轻,远期效果尚需进一步观察。BACKGROUND＆OBJECTIVE： The prognosis of patient with brain metastases from lung cancer is poor. In this study, we evaluated the efficacy and toxic side effect of ACNU combined with whole brain radiotherapy for brain metastases from lung cancer. METHODS： Thirty-five patients with brain metastases from lung cancer received whole brain radiotherapy with a dosage ranging from 36 to 40Gy in 20 fractions over 4 weeks. ACNU was administrated after the radiotherapy. The average dose of ACNU is 125mg per cycle with 4-6 weeks a cycle for 2-3 cycles. Hemogram and liver/renal function were regularly monitored. MRI was evaluated 3 months after radiation. RESULTS： No progressive disease was observed in this group of patients. Neurological symptoms in twenty-eight patients were relieved. Complete response （CR） was achieved in 5 cases, partial response （PR） in 26 cases and stable disease in 4 cases respectively. The objective response rate （CR ＋ PR） was 88.6% （31/35）. The 1-year survival ratewas 45.7% （16/35） and the median overal/ survival was 9.3 months. Common toxieities were brain edema and ACNU-related toxicity. CONCLUSION ： ACNU combined with radiotherapy is well tolerated and has activityagainst brain metastases from lung cancer.

关 键 词：肺癌 脑转移 尼莫司汀 放疗 

分 类 号：R739.41[医药卫生—肿瘤]