替莫唑胺联合全脑放疗治疗肺癌脑转移疗效评价.docVIP

替莫唑胺联合全脑放疗治疗肺癌脑转移疗效评价 　　[摘要] 目的 观察替莫唑胺联合全脑放疗治疗肺癌脑转移的临床疗效、不良反应及生存时间。 方法 回顾性分析43例肺癌脑转移患者，全脑放疗采用CT模拟定位三维适形放射治疗（3D-CRT）技术，1次/d，每周5次，共2周。在给予全颅脑放疗的同时给予替莫唑胺同期化疗，150 mg/（m2?d），每周期为28 d，根据患者的耐受情况可继续口服替莫唑胺4～6周期。利用Kaplan-Meier法计算生存率。 结果 43例患者客观缓解率为79.1%（34/43），其中CR为14.0%（6/43），PR为65.1%（28/43），PD 出现9例。截止至2016年11月30日，43例患者中死亡7例，其中1例因颅内病灶进展死亡，6例因合并转移其他重要脏器衰竭死亡。全组患者随访至截止日期的生存率（OS）和无疾病进展率（PFS）分别为 49.1%和 56.9%。替莫唑胺联合全脑放疗的不良反应较轻，患者均可耐受。 结论 替莫唑胺联合全脑放疗治疗肺癌脑转移有较好的临床疗效，同时患者对治疗可耐受。 　　[关键词] 替莫唑胺；全脑放疗；肺癌；脑转移 　　[中图分类号] R734.2 [文献标识码] B [文章编号] 1673-9701（2017）07-0075-04 　　[Abstract] Objective To observe the clinical efficacy， adverse reactions and survival time of temozolomide combined with whole brain radiotherapy in lung cancer. Methods 43 patients with lung cancer combined with brain metastases were retrospectively analyzed. Whole-brain radiotherapy was performed by CT simulated location and three-dimensional conformal radiotherapy（3D-CRT） technique， once a day， 5 times a week for 2 weeks. During the same time of whole brain radiotherapy， temozolomide concurrent chemotherapy was given， 150 mg/（m2?d）， each cycle for 28 days. According to the patients tolerance， the temozolomide could be orally given for 4 to 6 cycles continuously. The survival rate was calculated using the Kaplan-Meier method. Results The objective remission rate was 79.1% （34/43） in 43 patients， among whom CR was14.0%（6/43）， PR was 65.1%（28/43）， and 9 cases showed PD. As of November 30， 2016， among the 43 patients， 7 cases were died， of whom 1 case died of progressive intracranial lesions， and 6 cases died of other important organ failure due to metastasis. The overall survival（OS） and disease-free progression rate（PFS） were 49.1% and 56.9% respectively follow up to the deadline. The adverse reactions of temozolomide combined with whole brain radiotherapy were less， and the patients were able to tolerate. Conclusion Temozolomide combined with whole brain radiotherapy has a good clinical effect in the treatment of brain