立体定向全脑放射治疗联合沙利度胺对肺腺癌脑转移瘤近远期疗效及神经认知功能的影响  

The effect of SRT and WBRT combined with thalidomide on the short and long-term curative effect and neurocognitive function of patients with brain metastasis of lung adenocarcinoma

作　　者：顾香莲 陈荣 龚卿 陆松 方庆亮 GU Xiang-lian;CHEN Rong;GONG Qing(Department of Radiotherapy,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shang hai 200032,China;不详)

机构地区：[1]上海中医药大学附属龙华医院放疗科,上海200032

出　　处：《中国医学装备》2022年第3期67-70,共4页China Medical Equipment

摘　　要：目的:研究立体定向放射治疗(SRT)与全脑放射治疗(WBRT)同步联合沙利度胺治疗对肺腺癌脑转移瘤近远期疗效及神经认知功能的影响。方法:选取医院收治的99例肺腺癌脑转移患者,按照随机数表法将其分为观察组(44例)和对照组(45例)。对照组患者给予SRT+WBRT治疗,观察组患者给予SRT+WBRT联合沙利度胺治疗。对比两组患者功能状态卡氏功能量表(KPS)评分、病程、近期疗效和生存指标,以及治疗前,治疗后1周、2周及3周时的蒙特利尔认知评估量表(MoCA)评分、简易精神状态检查量表(MMSE)评分和不良反应情况。结果:两组患者肺癌及脑转移瘤疗效比较差异有统计学意义(U=5.34,U=6.22;P<0.05),观察组患者肺癌及脑转移瘤的总有效率及疾病控制率显著高于对照组,差异具有统计学意义(x_(肺癌)^(2)=6.23,χ^(2)=7.13;x_(脑转移瘤)^(2)=7.32,χ^(2)=6.14;P<0.05);观察组患者生存率和生存时间显著高于对照组,差异有统计学意义(χ^(2)=5.23,t=6.12;P<0.05);术后观察组患者KPS评分显著高于对照组(χ^(2)=7.34,P<0.05);对照组患者治疗前后MoCA得分比较差异有统计学意义(t=6.215,P<0.05),治疗后两组患者的MoCA得分均有明显改善,治疗后3周观察组患者MoCA得分明显高于对照组,差异具有统计学意义(t=9.842,P<0.05);两组患者MMSE评分比较差异有统计学意义(t=12.12,P<0.05);治疗后两组患者MMSE评分显著升高,观察组治疗后3周MMSE评分显著高于对照组,差异具有统计学意义(t=10.82,P<0.05);两组患者恶心呕吐、乏力、嗜睡、肝肾功能异常、白细胞减少、末梢神经炎等不良反应比较无差异。结论:SRT与WBRT同步联合沙利度胺能有效改善肺腺癌脑转移患者近远期疗效及MoCA和MMSE评分。Objective:To explore the effect of stereotactic radiotherapy(SRT) combined with whole brain radiotherapy(WBRT) on short and long-term curative effect and neurocognitive function of patients with brain metastases of lung adenocarcinoma.Methods:99 patients with brain metastasis of lung adenocarcinoma who admitted to hospital were selected and were randomly divided into observation group(44 cases) and control group(45 cases) according to random number table.The patients of control group were treated with SRT + WBRT,and the patients of observation group were treated with thalidomide on the basis of the treatment of control group.The score of Karnofsky performance status(KPS) scale,course of disease,short-term curative effect,survival index,as well as score of Montreal cognitive assessment(MoCA),score of mini-mental state examination(MMSE) and adverse reactions before treatment and 1 week,2 weeks and 3 weeks after treatment between two groups were compared.Results:There were significant differences in the curative effects of lung cancer and brain metastasis between the two groups(U=5.34,U=6.22,P<0.05).The total effective rate and disease control rate of lung cancer and brain metastasis in observation group were significantly higher than those in control group(x_(lung cancer)^(2)=6.23,χ^(2)=7.13,x_(brain metastasis)^(2)=7.32,χ^(2)=6.14,P<0.05).The survival rate and survival time of patients in observation group were significantly higher than those in control group(χ^(2)=5.23,t=6.12,P<0.05).The KPS score of patients in observation group was significantly higher than that in control group after operation(χ^(2)=7.34,P<0.05).There was significant difference in MoCA scores of control group between before and after treatment(t=6.215,P<0.05).After treatment,the MoCA scores both two groups were significantly improved.The MoCA score of observation group was significantly higher than that of control group at 3 weeks after treatment(t=9.842,P<0.05).There was significant difference in MMSE scores between the two groups(t=12.12

关 键 词：立体定向放射治疗(SRT) 全脑放射治疗(WBRT) 沙利度胺 肺腺癌脑转移 神经认知功能 疗效 生存时间 

分 类 号：R816.1[医药卫生—放射医学]