全脑放疗序贯吉非替尼治疗老年非小细胞肺癌伴脑转移的临床观察  

Clinical observation of gefitinib after whole brain radiation therapy in treatment of advanced non-small cell lung cancer with brain metastases in elderly patients

作　　者：储建华[1] 徐杰[1] 沈预程[1] 

机构地区：[1]海安县人民医院肿瘤科,江苏海安226600

出　　处：《临床肿瘤学杂志》2013年第7期656-658,共3页Chinese Clinical Oncology

摘　　要：目的探讨全脑放疗后序贯吉非替尼治疗老年非小细胞肺癌(NSCLC)伴脑转移患者的疗效及安全性。方法 30例老年NSCLC伴多发脑转移患者全脑放疗后口服吉非替尼250mg/d(治疗组),直至病情进展或出现不可耐受的毒副反应;选择同期30例老年NSCLC伴多发脑转移患者全脑放疗后给予吉西他滨(1250mg/m2静滴,d1、d8)治疗(对照组),21天为1周期,共4个周期。比较两组患者的近期疗效、中位无进展生存期、中位总生存期及毒副反应。结果治疗组颅内病灶有效率、疾病控制率和全身病变有效率、疾病控制率分别为43.3%、80.0%、40.0%和66.7%,对照组分别为13.3%、46.7%、13.3%和30.0%,两组差异均有统计学意义(P<0.05)。治疗组的中位无进展生存期和中位生存期分别为7.4个月和12.8个月,对照组分别为4.2个月和8.2个月,两组差异均有统计学意义(P<0.05)。对照组恶心呕吐、骨髓抑制的发生率分别为53.3%、66.7%,治疗组分别为3.3%、13.3%,两组差异均有统计学意义(P<0.05)。两组腹泻、疲乏、肝功能异常等毒副反应的差异均无统计学意义(P>0.05)。结论全脑放疗后序贯吉非替尼治疗老年NSCLC伴脑转移的疗效确切,患者预后改善,且毒副反应可耐受。Objective To evaluate the efficacy and safety of gefitinib for non-small cell lung cancer（NSCLC） with brain me- tastases in elderly patients. Methods After whole brain radiation therapy,gefitinib （250rag/d） was given in 30 elderly NSCLC pa- tients with multiple brain metastases（ treatment group） until disease progression or intolerable toxicity. After whole brain radiation ther- apy, intravenous infusion of gemicitabine（ 1250mg/m2 , d1 , d8 ） was used in other 30 patients（ control group） every 3 weeks for four cy- cles. The short-term effects, median progression-free survival, median overall survival and toxicity were compared between groups. Re- suits In treatment group, intracranial metastases＇ effective rate and control rate, the total effective rate and disease control rate were 43.3% and 80. 0% ,40. 0% and 60. 7% , while they were 13.3% and 46. 7% , 13.3% and 30. 0% in control group with significant differences（P 〈 0. 05 ）. In treatment group, median progression-free survival and median overall survival were 7.4 months and 12. 8 months, while they were 4.2 months and 8.2 months in control group was statistically significant difference（ P 〈 0.05 ）. The rates of nausea/vomiting and bone marrow suppression in treatment group were 53.3% and 66. 7% , while they were 3.3% and 13.3% with statistically significant difference（ P 〈 0. 05 ）. There was no significant difference in the incidence of diarrhea, fatigue and abnormac liver function（ P 〉 0. 05）. Conclusion Gefitinib treatment of elderly patients with NSCLC with brain metastases is effective and can improve the prognosis of patients, and the toxicity can be tolerated.

关 键 词：非小细胞肺癌 老年 多发性脑转移 吉非替尼 吉西他滨 

分 类 号：R734.2[医药卫生—肿瘤]