厄洛替尼同步全脑放疗二线治疗无症状的多发性肺腺癌脑转移患者的临床疗效观察  

Efficacy of Erlotinib Concurrent with Whole Brain Radiotherapy as Second-line Therapy for Lung Cancer Patients with Asymptomatic Multiple Brain Metastases

作　　者：龙建林[1] 杨宁[1] 贺竞[1] 

机构地区：[1]四川大学华西广安医院,四川广安638000

出　　处：《肿瘤学杂志》2016年第8期622-626,共5页Journal of Chinese Oncology

摘　　要：[目的]比较厄洛替尼单药和厄洛替尼同步全脑放疗二线治疗无症状的多发性肺腺癌脑转移患者的效果及安全性。[方法]选择全身化疗后进展的、无症状的多发性肺腺癌脑转移患者39例,通过随机数字法分为厄洛替尼单药治疗组和厄洛替尼同步全脑放疗治疗组。厄洛替尼单药组(19例)给予口服厄洛替尼150mg/d直到病情进展或出现不能耐受的副作用;厄洛替尼同步全脑放疗组给予全脑放疗(37.5Gy/15次,3周),厄洛替尼150mg/d,从放疗的第一天开始口服直到病情进展或出现不能耐受的副作用。主要观察指标是比较两组患者的客观有效率(ORR)、神经系统无进展生存期(n PFS)、无进展生存期(PFS)、生存期(OS)及不良反应的发生情况。[结果]厄洛替尼单药组与厄洛替尼同步全脑放疗组的ORR分别为52.6%和85.0%(P=0.041);中位n PFS分别9.4个月和13.7个月(P=0.001);中位PFS分别为6.9个月和8.5个月(P=0.228),中位OS为15.1个月和18.8个月(P=0.046)。无4度及以上不良反应发生。[结论]与厄洛替尼单药相比,厄洛替尼同步全脑放疗二线治疗无症状的多发性肺腺癌脑转移患者,能够明显提高客观有效率、局部神经系统无进展生存期、延长患者的生存期,同时没有明显增加患者的不良反应。[Objective] To evaluate the efficacy and safety of erlotinib or erlotinib with concurrent whole brain radiotherapy（WBRT） as second-line therapy in lung cancer patients with asymptomatic multiple brain metastases.[Methods] Thirty nine lung cancer patients with asymptomatic multiple brain metastases,who were progressed after first-line platin-base doublet chemotherapy,were randomly assigned in two groups：19 patients were treated with erlotinib 150 mg daily（Group E）until disease progression or unacceptable toxicity;20 patients received erlotinib 150 mg daily and concurrent WBRT（group E＋WBRT） with total dose of 37.5Gy（15 fractions） for 3 weeks.The objective response rate（ORR）,neurological progress-free survival（n PFS）,progress-free survival（PFS）,overall survival（OS）and adverse effects were compared between two groups.[Results] The ORR in group E and Group E ＋WBRT was 52.6% and 85.0%（P =0.041）;the median n PFS was 9.4 months and 13.7 months（P=0.001）;the median PFS was 6.9 months and 8.5 months（P=0.228）;the median OS was 15.1 months and 18.8 months（P=0.046）,respectively.No grade 4 or higher adverse effects was observed in either group.[Conclusion] Erlotinib concurrent with WBRT can improve ORR,median n PFS,median OS and does not increase the treatment related toxicity for lung cancer patients with asymptomatic multiple brain metastases.

关 键 词：厄洛替尼 全脑放疗 脑转移 二线治疗 肺腺癌 

分 类 号：R734.2[医药卫生—肿瘤]