替莫唑胺联合全脑放疗对乳腺癌脑转移患者的疗效评价  

Efficacy Evaluation of Temozolomide plus Concomitant Whole-Brain Radiation Treatment in Breast Cancer Patients with Brain Metastases

作　　者：毛英[1] 刘黎[1] 张匠 骆雯[1] 夏璐[1] 

机构地区：[1]四川省遂宁市中心医院肿瘤中心,四川遂宁629000

出　　处：《医学临床研究》2016年第8期1542-1543,1546,共3页Journal of Clinical Research

摘　　要：[目的]探讨替莫唑胺联合全脑放疗对乳腺癌脑转移患者的近期疗效及安全性。[方法160例均无手术指征的乳腺癌脑转移患者，分为单纯放疗组（A组）和联合治疗组（B组），每组各30例，A组，放疗3000cGy／10次，B组在放疗基础上联合替莫唑胺75rag／（m2·d），口服，从放疗开始至结束共服用14d。治疗结束2个月后通过MRI检查评估两治疗组近期疗效，比较两组客观缓解率，不良反应发生率。[结果]治疗结束2个月后A组和B组客观缓解率分别为66．67％（20／30）和76．67％（23／30），两组相比较差异无显著性（P〉0．05）；B组神经系统症状改善率为90％（27／30），明显高于A组70％（21／30）（P〈0．05）；B组骨髓抑制和胃肠道反应两项不良反应发生率为较A组高，且差异有显著性（P〈0．05）。[结论]替莫唑胺联合全脑放疗未能提高乳腺癌脑转移患者短期客观缓解率，不良反应较单纯放疗明显，但患者神经系统症状改善明显。[Objective]To investigate the efficacy and safety of whole-brain radiation treatment （WBRT） com- bined with temozolomide （TMZ） in the treatment of brain metastases （BM） from breast cancer. [Methods]This randomized study included 60 patients with newly diagnosed intraparenchymal BMs from breast cancer, unsuitable for surgery or radiosurgery. The patients were divided into the WBRT group （ n =30） and the WBRT ＋ TMZ group （ n =30）. Patients in the WBRT group received conformal WBRT （3000 cGy/10 times）, while patients in the WBRT ＋ TMZ group received concomitant TMZ administered at a dosage of 75 mg/m2/day orally during the irradiation period for 14 days in addition to conformal WBRT （3000 cGy/10 times）. The objective response rate （ORR） 2 months after the end of treatment, defined as a p^tial or complete response on systematic brain MRI （modified WHO criteria）, was observed and the incidence of adverse reactions and the improvement of neurologi- cal symptoms were investigated and compared between patients of the two groups. [Results]The objective re- sponse rate （ORR） 2 months after the end of treatment was 66.67G in the WBRT group and 76.67% in the WBRT ＋ TMZ group＋ the difference was not statistically different （ P〈0.05）. The nervous system symptoms improved markedly in the WBRT ＋ TMZ group 90% （27/30）, while it was 70 % （21/30） in WBRT group （ P 〈 0.05）, but the adverse reactions were more obvious in this group as well （ P〈0.05）. [Conclusion]WBRT com- bined with TMZ did not significantly improve local control and survival in patients with BMs from breast cancer. The nervous system symptoms improved markedly in the WBRT ＋ TMZ group but with more adverse reactions.

关 键 词：抗肿瘤药/治疗应用 莫唑胺/治疗应用 乳腺肿瘤/放射疗法 乳腺肿瘤/药物疗法 肿瘤转移 

分 类 号：R737.9[医药卫生—肿瘤]