放化综合治疗在脑转移癌治疗中的临床应用研究  

Radiation combined chemotherapy in the treatment of brain metastases

作　　者：高力英[1] 冉俊涛[1] 郭浩楠 李益民[1] 董方[1] 韩鹏柄 苏群[1] 

机构地区：[1]甘肃省肿瘤医院放疗科,甘肃兰州730050 [2]甘肃省中医学院,甘肃兰州730000

出　　处：《现代肿瘤医学》2015年第2期195-197,共3页Journal of Modern Oncology

基　　金：兰州市科技计划项目资助(编号:2011-2-37)

摘　　要：目的:观察放化综合治疗脑转移癌的近期疗效与安全性。方法:62例脑转移癌患者随机分为放化疗组与单纯放疗组。其中化疗联合组31例,非小细胞肺癌脑转移患者入组替莫唑胺联合放疗组、乳腺癌脑转移患者入组卡培他滨联合放疗组;31例为单纯放疗组。替莫唑胺联合放疗组给予替莫唑胺[75mg/(m2·d)]至放疗结束,卡培他滨组给予[625mg/(m2·d),2次/d,连用4周]。两组均联合2周三维适形头部放疗,总剂量42Gy(3Gy,5f/w),其中全脑30Gy/10f,病灶区补量12Gy/4f;单纯放疗组仅予42Gy三维适形头部放疗,其中全脑30 Gy,病灶区补量12 Gy。联合放化疗组放疗结束后继续给予2个周期替莫唑胺[每周期150mg/(m2·d)],连续服用5d,28d为1个周期;卡培他滨组给予[每周期825mg/(m2·d),2f/d,d1-14],连续服用14d,28d为1个周期。结果:联合放疗组与单纯放疗组的客观有效率分别为80.63%、64.5%,差异无统计学意义(P>0.05);骨髓抑制发生率分别为70.96%、54.84%,胃肠道毒副反应发生率分别为61.29%、41.94%,差异均无统计学意义(P>0.05)。结论:替莫唑胺联合放疗以及卡培他滨联合放疗治疗非小细胞肺癌及乳腺癌脑转移安全、有效,但是近期疗效对比单纯放疗差异不显著。Objective：To study the recent efficacy and safety of comprehensive treatment of brain metastasis carcinoma.Methods：All 62 patients with brain metastatic carcinoma were randomly divided into the radiation and chemotherapy and radiotherapy alone group.Patients with brain metastases from non-small cell lung cancer in the group for the mothiazole amine adjuvant radiotherapy group of patients with brain metastases from breast cancer was in the group of combined radiotherapy group and 31 cases of simple radiotherapy group.For the mothiazole amine adjuvant radiotherapy group was given.Temozolomidecapsules [75mg/（m2 · d）],until the end of radiotherapy,capecitabine group was given[625mg/（m2 · d）],2 times/d,4 weeks.Two groups have combined two weeks of three-dimensional conformal radiation therapy,head 42 Gy total dose （3 Gy,5 f/week）,30Gy/l0f,the whole brain lesions area filling quantity 12Gy/4f.Simple radiotherapy group grant only 42Gy three-dimensional conformal radiation therapy,the head of 30Gy,whole brain lesions area filling quantity 12Gy.Combined radiation and chemotherapy after radiotherapy continue to treat two cycles,for Temozolomidecapsules [per cycle 150rmg/（m2 · d）],for 5 d,28 d to 1 cycle ; Capecitabine group was given [825 mg/（m2 · d） per cycle,2f/d,d1-14）,for 14d and 28d of 1 cycle.Results：Effective rates of the combined radiotherapy with pure objective effective radiation group were 80.63％ and 64.5％ （P ＞ 0.05）,there was no statistically significant difference.Incidence of bone marrow suppression were 70.96％ and 54.84％ respectively（P ＞0.05）,the incidence of gastrointestinal side effects were 61.29％,41.94％,and the differences were not statistically significant.Conclusion：The Temozolomide capsules combined radiotherapy and capecitabine combined radiation treatment on brain metastases from non-small cell lung cancer,breast cancer is safe,effective,but no significant difference compared with pure radiation alone.

关 键 词：替莫唑胺 卡培他滨 非小细胞肺癌 乳腺癌 脑转移癌 

分 类 号：R730.6[医药卫生—肿瘤]