全脑放疗联合替莫唑胺治疗肺癌脑转移疗效观察  

Study of temozolomide and whole-brain radiotherapy for non-small cell lung cancer patients with brain metastases

作　　者：张明[1] 冉俊涛[1] 王小虎[1] 董方[1] 苏群[1] 韩鹏炳[1] 李益民[1] 高力英[1] 

机构地区：[1]甘肃省肿瘤医院放疗科,甘肃兰州730050

出　　处：《现代肿瘤医学》2016年第3期371-374,共4页Journal of Modern Oncology

基　　金：兰州市科技局资助项目(编号:2011-2-37)

摘　　要：目的:探讨全脑放疗(WBRT)联合替莫唑胺(TMZ)治疗非小细胞肺癌(NSCLC)脑转移的疗效。方法:回顾分析本院2010年-2014年收治的37例接受WBRT联合TMZ同步治疗及TMZ辅助治疗的NSCLC脑转移患者疗效。WBRT剂量30Gy,TMZ放疗同步口服75mg/(m^2·d)序贯给予TMZ 150~200mg/(m^2·d),连续5天,28天为1周期,3~6周期。结果:完全缓解10.8%(4/37),部分缓解40.5%(15/37)。中位无进展生存时间和中位生存时间分别为8和10个月。最常见不良反应恶心、呕吐,中性粒细胞减少和血小板减少的发生率分别为59.5%(22/37),32.4%(12/37),35.1%(13/37)。结论:WBRT联合TMZ同步治疗及TMZ辅助化疗治疗NSCLC脑转移癌安全有效,耐受性良好,不良反应轻,可作为脑转移癌放化疗综合治疗模式之一进行深入研究。Objective：To analyze the treatment outcome and prognosis of non-small cell lung cancer（NSCLC） patients with brain metastases（BM） treated by temozolomide（TMZ） and whole-brain radiotherapy（WBRT）.Methods：From 2010 to 2014,thirty seven NSCLC with BM received 30Gy WBRT with concomitant TMZ 75mg/（m^2·d） for ten days,followed by TMZ 150-200mg/（m^2·d） for 5 days every 28 days,up to six cycles.Results：Four complete responses（10.8%） and 15 partial responses（40.5%） were achieved.The overall median survival was 10 months and the median progression-free survival was 8 months.The regimen appeared to be well tolerated,the most frequent toxicities included nausea and vomiting（59.5%,22/37）,neutropenia（32.4%,12/37）,thrombocytopenia（35.1%,13/37）.Conclusion：This study shows an encouraging objective response rate of brain metastases.The concomitant use of WBRT and TMZ with adjuvant TMZ chemotherapy appears to be an active,well-tolerated regimen.The study also suggests the need for further investigation of the regimen compared with others.

关 键 词：脑转移癌 全脑放疗 替莫唑胺 

分 类 号：R739.91[医药卫生—肿瘤]