Iressa与放疗同期治疗非小细胞肺癌脑转移的临床效果及对表皮生长因子的影响  

Clinical effect of Iressa combined with radiotherapy treating non-small cell lung cancer earlier brain metastases and influence on EGFR

作　　者：林珊[1] 韩波[1] 高纯子[1] 孟玲楠[1] 

机构地区：[1]哈尔滨医科大学附属第一医院肿瘤科二病房,黑龙江哈尔滨150001

出　　处：《中国医药导报》2015年第32期21-24,共4页China Medical Herald

基　　金：黑龙江省卫生厅科研课题(2012-547)

摘　　要：目的探讨Iressa与放疗同期治疗非小细胞肺癌脑转移的临床效果及对表皮生长因子受体（EGFR）的影响。方法选取2008年3月~2012年12月在哈尔滨医科大学附属第一医院治疗的86例非小细胞肺癌脑转移患者,按照随机数字表法分为研究组1（全脑放疗同时口服Iressa,43例）和研究组2（全脑放疗后口服Iressa,43例）。分析患者治疗前、后疾病控制率、血清中非小细胞肺癌抗原（LTA）、癌胚抗原（CEA）及EGFR含量以及随访患者后期生存质量等。结果研究组1的部分缓解率（48.8%）、病情进展率（14.0%）、有效率（65.1%）以及疾病控制率（86.0%）与研究组2（20.9%、37.2%、30.2%、62.8%）比较,差异有统计学意义（P〈0.05）;治疗后,研究组1、研究组2中LTA、CEA及EGFR较治疗前均明显下降,差异有统计学意义（P〈0.05或P〈0.01）,且研究组1的LTA、EGFR水平低于研究组2,差异有统计学意义（P〈0.05）。Kaplan Meier法分析结果：研究组1中位肿瘤无进展生存时间为12.7个月（95%CI：2.7~6.1）,研究组2为7.1个月（95%CI：2.1~6.3）。研究组2的疲乏、呕吐、恶心的发生率高于研究组1,差异有统计学意义（P〈0.05）,而腹泻、骨髓抑制以及痤疮样皮疹的发生率,差异无统计学意义（P〉0.05）。结论 Iressa与放疗同期治疗非小细胞肺癌脑转移临床疗效确切,其治疗效果优于放疗后口服Iressa,其作用与Iressa与放疗同期治疗降低患者EGFR、增加对肿瘤细胞放射的敏感性有关。Objective To explore the clinical effect of Iressa combined with radiotherapy treating non-small cell lung cancer earlier brain metastases and the influence on epidermal growth factor receptor（EGFR）. Methods From March2008 to December 2012, in the First Affiliated Hospital of Harbin Medical University, 86 patients with non-small cell lung cancer earlier brain metastases were selected, and according to random number table, they were divided into study group 1（whole brain radiotherapy combined with oral Iressa, 43 cases） and study group 2（oral Iressa after whole brain radiotherapy, 43 cases）. The disease control rate, serum antigen in non-small cell lung cancer（LTA）, CEA and EGFR content, life quality of followe-up late of patients before and after treatment were analyzed. Results The rates of partial remission（48.8%）, disease progression（14.0%）, efficient（65.1%） and disease control（86.0%） in study group 1 were compared with those in study group 2（20.9%, 37.2%, 30.2%, 62.8%）, the differences were statistically significant（P〈0.05）; after treatment, LTA, CEA and EGFR in two groups decreased significantly than before treatment, the differences were statistically significant（P〈0.05 or P〈0.01）, and LTA, EGFR in study group 1 were lower than those in study group2, the differences were statistically significant（P〈0.05）. The results of Kaplan Meier analysis showed that median progression-free survival time of study group 1 was 12.7 months（95%CI： 2.7- 6.1）, that of study group 2 was 7.1 months（95% CI： 2.1-6.3）. The occurrence rates of fatigue, vomiting, nausea in study group 2 were lower than those in study group 1, the differences were statistically significant（P〈0.05）; The occurrence rates of diarrhea, bone marrow suppression,and acne-like rash of two groups were compared, the differences were not statistically significant（P〈0.05）. Conclusion Iressa combined with radiotherapy treating non-small cell lung cancer of brain metastases is effective

关 键 词：IRESSA 全脑放疗 非小细胞肺癌脑转移 表皮生长因子受体 

分 类 号：R734.2[医药卫生—肿瘤]