不同分割模式调强放疗治疗EGFR突变阳性非小细胞肺癌脑部寡转移疗效的研究  

Clinical efficacy of IMRT with different fractionation modes in treating EGFR mutation-positive non-small cell lung cancer with oligonucleogenous metastasis

作　　者：赵悦[1] 谢赟[2] 王洪兵 魏冬冬[1] 任佳佳 寇晓雪 ZHAO Yue;XIE Yun;WANG Hongbing(Cangzhou Central Hospital,Hebei,Cangzhou 061000,China;不详)

机构地区：[1]河北省沧州市中心医院,061000 [2]河北省疾病预防控制中心

出　　处：《河北医药》2021年第17期2594-2597,共4页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题计划(编号:20200331)。

摘　　要：目的探讨调强放疗治疗表皮生长因子受体(EGFR)突变阳性非小细胞肺癌脑部寡转移(1~3个)的剂量分割模式。方法选择2017年1月至2019年6月收治的EGFR突变阳性非小细胞肺癌脑部寡转移(1~3个)患者87例,给予酪氨酸激酶(TKI)治疗联合不同分割模式放疗,根据处方剂量分为A组:60 Gy/30F,B组60 Gy/20F,C组60 Gy/15F,评价与TKI联合最佳的放疗分割剂量。结果C组的完全缓解(CR)率与有效(RR)率明显高于A组,差异有统计学意义(P<0.05),C组的CR率与RR率高于B组,但差异无统计学意义(P>0.05)。6个月1年生存率比较,C组高于B组和A组(P<0.05),但C组与B组间差异无统计学意义(P>0.05),C组1年生存率高于A组,差异有统计学意义(P<0.05)。3组不良反应发生情况存在差异,但差异无统计学意义(P>0.05)。3个月和6个月认知障碍发生情况比较,C组较B组和A组发生率高,但差异无统计学意义(P>0.05)。3个月和6个月放射性脑损伤发生情况各组间比较,C组高于B组和A组,但差异无统计学意义((P>0.05))。结论60 Gy/15F剂量分割模式在CR率和RR率上更具优势,同时在6个月生存率和1年生存率上更具优势,不良反应可以耐受。Objective To investigate the clinical effects of intensity modulated radiotherapy(IMRT)with different fractionation modes in treating EGFR mutation-positive non-small cell lung cancer with oligonucleogenous metastasis in the brain(1~3).Methods A total of 87 patients with EGFR mutation-positive non-small cell lung cancer with oligonucleogenous metastasis in the brain(1~3)who were treated in our hospital from January 2017 to June 2019 were enrolled in the study.The patients were treated by TKI therapy combined with different fractionated radiotherapy(group A:60Gy/30F,group B:60Gy/20F,group C:60Gy/15F).The the best fractionated radiotherapy dose combined with TKI was analyzed.Results The CR rate and RR rate in group C were significantly higher than those in group A(P<0.05),which in group C were higher than those in group B,but,there were no significant differences between group C and group B(P>0.05).The 6-month and 1-year survival rates in group C were significantly higher than those in group A and group B(P<0.05),however,there were no significant differences between group C and group B(P>0.05).The incidence rates of cognitive impairment at 3 months and 6 months in group C were higher than those in group B and group A,but the differences were not statistically significant(P>0.05).Moreover the incidence rates of radiation brain injury at 3 months and 6 months in group C were higher than those in group B and group A,however,the differences were not statistically significant(P>0.05).Conclusion The 60Gy/15F dose segmentation mode has advantages in CR rate and RR rate,and has advantages both in 6-month and 1-year survival rate,with the adverse reactions being tolerable.

关 键 词：分割模式 调强放疗 非小细胞肺癌 寡转移 治疗结果 

分 类 号：R734.2[医药卫生—肿瘤]