EGFR突变与替莫唑胺联合IGRT大分割放射治疗非小细胞肺癌脑转移瘤疗效的相关性  

Correlation between EGFR Mutation and the Efficacy of Temozolomide Combined with IGRT Hyperfractionated Radiotherapy for Non-small Cell lung Cancer Brain Metastases

作　　者：高晖[1] 黄凤仙[1] 王海鹏[2] 曹席明 于娇[1] GAO Hui;HUANG Feng-xian;WANG Hai-peng;CAO Xi-ming;YU Jiao(Department of Radiotherapy,Shaanxi Provincial People's Hospital,Xi'an,Shaanxi,710068,China;Department of Medical Oncology,Shanxi Provincial People's Hospital,Xi'an,Shaanxi,710068,China)

机构地区：[1]陕西省人民医院放疗科,陕西西安710068 [2]陕西省人民医院肿瘤内科,陕西西安710068

出　　处：《现代生物医学进展》2022年第16期3081-3085,共5页Progress in Modern Biomedicine

基　　金：陕西省重点研发计划项目(2021SF-306)。

摘　　要：目的:研究表皮生长因子受体(EGFR)突变对替莫唑胺联合图像引导大分割放射(IGRT)治疗非小细胞肺癌脑转移瘤临床疗效的影响。方法:选择2015年1月到2018年12月在我院接受治疗的非小细胞肺癌脑转移患者86例,根据是否出现EGFR突变分为对照组(EGFR未突变组)和研究组(EGFR突变组),每组43人,两组患者均接受替莫唑胺联合IGRT大分割放射治疗。比较两组患者临床治疗疗效、不良反应发生情况、复发时间、生存时间和生活质量。结果:研究组患者临床治疗总有效率较对照组患者高(P<0.05)。研究组患者治疗后复发时间和生存时间均显著高于对照组患者(P<0.05)。两组患者治疗期间头痛、恶心、疲乏以及神经毒性等不良反应的发生情况比较无显著差异(P>0.05)。两组患者治疗前生活质量KarnofSky活动状态评分(KPS)和肺癌相关症状量表(LCSS评分)无显著差异(P>0.05);治疗后,研究组患者KPS评分显著高于对照组(P<0.05),而LCSS评分显著低于对照组患者(P<0.05)。结论:替莫唑胺联合IGRT大分割放射治疗EGFR突变的非小细胞肺癌脑转移瘤临床疗效更好,并且治疗后患者生活质量更优。Objective: To study the effect of epidermal growth factor receptor(EGFR) mutations on the clinical efficacy of temozolomide combined with Image Guided Radiation Therapy(IGRT) hyperfractionated radiotherapy for non-small cell lung cancer brain metastases. Methods: Eighty-six patients with brain metastases from non-small cell lung cancer who were treated in our hospital from January 2015 to December 2018 were selected. They were divided into control group(EGFR non-mutated group) and study group(EGFR mutation group) according to whether EGFR mutations occurred. There were 43 persons in each group, and both groups received temozolomide combined with IGRT hyperfractionated radiotherapy. Compare the clinical treatment efficacy, adverse reactions, recurrences, survival time and quality of life between the two groups of patients. Results: The total effective rate in the study group was higher than that in the control group(P<0.05). The recurrence time and survival time of patients in the study group were higher than those in the control group after treatment(P<0.05). There was no difference in the incidence of headache, malignancy, fatigue and neurotoxicity between the two groups of patients during treatment(P>0.05). There was no difference in the KPS and LCSS scores of the two groups of patients before treatment(P>0.05);after treatment, the KPS scores of the study group were higher than those of the control group(P<0.05),while the LCSS scores were lower than those of the control group(P>0.05). Conclusion: Temozolomide combined with IGRT hyperfractionated radiotherapy has a better clinical effect in the treatment of EGFR-mutated non-small cell lung cancer brain metastases, and the patient’s quality of life after treatment is better.

关 键 词：表皮生长因子受体 替莫唑胺 放疗 非小细胞肺癌 脑转移 

分 类 号：R734.2[医药卫生—肿瘤]