同期化疗辅助全脑放疗联合三维适形调强局部加量治疗乳腺癌脑转移的临床研究  

Clinical efficacy of concurrent adjuvant chemotherapy for whole brain radiotherapy combined with 3-dimensional conformal intensity modulated radiotherapy on the brain metastasis in breast cancer

作　　者：张修龙 张丽华[1] 

机构地区：[1]上海交通大学附属第六人民医院肿瘤放疗科,上海200233

出　　处：《癌症进展》2017年第12期1449-1452,共4页Oncology Progress

摘　　要：目的探讨同期化疗辅助全脑放疗联合三维适形调强局部加量治疗乳腺癌脑转移的临床疗效。方法回顾性分析92例乳腺癌脑转移患者的临床资料,依据治疗方法的不同将患者分为对照组(n=48)和试验组(n=44)。对照组患者采用全脑放疗联合三维适形调强局部加量治疗,试验组患者在上述放疗的基础上给予同期辅助化疗。评估两组患者的临床疗效、不良反应发生情况及生存质量。结果两组患者均顺利完成治疗。试验组患者的总有效率为31.8%(14/44),高于对照组的12.5%(6/48),差异有统计学意义(P﹤0.05);试验组和对照组患者的疾病控制率分别为86.4%(38/44)和75.0%(36/48),差异无统计学意义(P﹥0.05)。试验组患者的中位无进展生存时间(PFS)为4.6个月(95%CI:3.694~5.506),中位总生存时间(OS)为8.3个月(95%CI:6.739~9.861);对照组患者的中位PFS为3.3个月(95%CI:1.893~4.707),中位OS为6.0个月(95%CI:5.103~6.897)。试验组患者的中位PFS和中位OS均长于对照组,差异均有统计学意义(P﹤0.05)。两组患者均出现不同程度的不良反应,主要的3~4级不良反应为胃肠道反应、血小板减少和头痛,但患者均可耐受,均未中止治疗。试验组患者胃肠道反应的发生率为50.00%(22/44),明显高于对照组的16.67%(8/48),差异有统计学意义(P﹤0.01);其余不良反应的发生率比较,差异均无统计学意义(P﹥0.05)。治疗后两组患者的KPS评分均提高,且试验组患者的KPS评分明显高于对照组,差异均有统计学意义(P﹤0.01)。结论对乳腺癌脑转移患者进行同期化疗辅助全脑放疗联合三维适形调强局部加量治疗可获得较好的临床疗效,且不良反应可耐受。Objective To investigate the clinical efficacy of concurrent adjuvant chemotherapy for whole brain radiotherapy combined with 3-dimensional conformal intensity modulated radiotherapy（3 D-IMRT） on the brain metastasis in breast cancer. Method 92 cases of breast cancer patients with brain metastasis were retrospectively analyzed, and were stratified as control group（n=48） and study group（n=44） as per respective treatment administered. Patients in control group were all treated with whole brain radiotherapy in combination with 3 D-IMRT; and concurrent adjuvant chemotherapy was additionally administered. The efficacy, adverse reactions and quality of life were observed and compared. Result All patients had completed treatment. The overall response rate（RR） in study group was 31.8%（14/44）, higher than that in control group at 12.5%（6/48）, with significant difference observed（P〈0.05）; the disease control rate（DCR） was 86.4%（38/44） and 75.0%（36/48） in study group and control group, respectively, with no significant difference noted（P〈0.05）. The median progression-free survival（PFS） was 4.6（95%CI： 3.694～5.506） months and the median overall survival（OS） was 8.3（95%CI： 6.739～9.861） months in study group, and were better than those in the control group at 3.3（95%CI：1.893～4.707） months and 6.0（95%CI： 5.103～6.897） months, respectively（P〈0.05）. All the patients were observed with adverse reactions, and the main grade III/IV toxicities were gastrointestinal reactions, thrombocytopenia and headache,while all were tolerated, and none resulted in treatment interruptions. The incidence of gastrointestinal reactions in study group was 50.00%（22/44）, which was higher than that in control group at 16.67%（8/48）, the difference was of statistical significance（P〈0.01）; while the incidence of other adverse reactions were similar between the two groups（P〈0.05）. The KPS score was significantly improved after treatment, and the i

关 键 词：乳腺肿瘤 脑转移 全脑放疗 三维适形调强放疗 化疗 

分 类 号：R737.9[医药卫生—肿瘤]