SIB-IGRT联合埃克替尼治疗EGFR突变型肺腺癌脑转移的前瞻性随机对照研究  

SIB-IGRT combined with icotinib in the treatment of EGFR-mutant lung adenocarcinoma brain metastases:a prospective randomized controlled study

作　　者：罗鹏辉 莫敦昌 黄尚校 邓慧芬 梁小燕 吴美华 王斌强 黄剑锋 LUO Penghui;MO Dunchang;HUANG Shangxiao;DENG Huifen;LIANG Xiaoyan;WU Meihua;WANG Binqiang;HUANG Jianfeng(Department of Radiotherapy,The Second Nanning People′s Hospital,Nanning 530031,Guangxi,China;Department of Pathology,The Second Nanning People′s Hospital,Nanning 530031,Guangxi,China;Department of Thoracic Surgery,The Second Nanning People′s Hospital,Nanning 530031,Guangxi,China)

机构地区：[1]南宁市第二人民医院暨广西医科大学第三附属医院放疗科,广西南宁市530031 [2]南宁市第二人民医院暨广西医科大学第三附属医院病理科,广西南宁市530031 [3]南宁市第二人民医院暨广西医科大学第三附属医院胸外科,广西南宁市530031

出　　处：《微创医学》2022年第5期545-549,共5页Journal of Minimally Invasive Medicine

基　　金：广西区卫健委自筹经费科研课题(编号:Z20190237)。

摘　　要：目的探讨同期加量的图像引导调强放疗(SIB-IGRT)联合埃克替尼治疗表皮生长因子受体(EGFR)突变型肺腺癌脑转移的效果。方法纳入70例EGFR突变型肺腺癌脑转移患者,按照随机数字表法将其分为同步治疗组和先放疗组,各35例。同步治疗组于埃克替尼靶向治疗第1天开始进行SIB-IGRT,先放疗组于埃克替尼靶向治疗前15 d开始进行SIB-IGRT。比较两组患者的近期疗效[疾病控制率(DCR)、客观缓解率(ORR)]、远期疗效[无进展生存时间(PFS)],以及不良反应发生情况。结果(1)同步治疗组患者的ORR、DCR均高于先放疗组,PFS长于先放疗组(均P<0.05);同步治疗组患者的恶心、呕吐、疲乏发生率均低于先放疗组(均P<0.05)。结论SIB-IGRT联合埃克替尼同步治疗可提高EGFR突变型肺腺癌脑转移患者的DCR及ORR,并可延长患者的PFS,不良反应较少,值得临床推广应用。Objective To investigate the effect of simultaneous integrated boost image-guided radiation therapy(SIB-IGRT)combined with icotinib in the treatment of epidermal growth factor receptor(EGFR)-mutant lung adenocarcinoma brain metastases.Methods A total of 70 patients with EGFR-mutant lung adenocarcinoma brain metastases were enrolled,and they were divided into synchronous treatment group and radiotherapy-first group according to the random number table method,with 35 cases in each group.The SIB-IGRT was performed in the synchronous treatment group on the first day of icotinib targeted therapy,while the SIB-IGRT was performed in the radiotherapy-first group 15 days before icotinib targeted therapy.The short-term efficacy[disease control rate(DCR),objective response rate(ORR)],long-term efficacy[progression-free survival(PFS)],and incidence of adverse reactions were compared between the two groups.Results(1)The ORR and DCR were higher and the PFS was longer in the synchronous treatment group than those in the radiotherapy-first group(all P<0.05).The incidences of nausea,vomiting,and fatigue were lower in the synchronous treatment group than those in the radiotherapy-first group(all P<0.05).Conclusion Synchronous treatment of SIB-IGRT combined with icotinib can improve the DCR and ORR of patients with EGFR-mutant lung adenocarcinoma brain metastases and prolong the PFS of patients with less adverse reactions,which is worthy of clinical promotion and application.

关 键 词：同期加量的图像引导调强放疗 埃克替尼 EGFR突变 肺腺癌 脑转移 前瞻性 随机对照 临床疗效 

分 类 号：R734.2[医药卫生—肿瘤]