全脑放疗联合替莫唑胺治疗非小细胞肺癌脑转移瘤的效果评价

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摘要目的观察全脑放疗联合替莫唑胺治疗非小细胞肺癌（NSCLC）脑转移瘤的效果及不良反应。方法选取我院2014年5月～2017年5月收治的56例非小细胞肺癌脑转移瘤患者作为研究对像，按照随机分组方法分为研究组及对照组，每组28例。研究组采用全脑放疗同步口服替莫唑胺胶囊化疗，全脑放疗剂量40 GY/20 F，替莫唑胺75 mg/（m2·d）。对照组采用单纯全脑放疗，其放疗剂量和方法同研究组。治疗期间及治疗结束后比较两组患者的相关不良反应；放疗结束后1个月复查脑增强MRI，比较两组的总有效率（RR）、无进展生存期及总生存期。结果研究组的RR高于对照组，差异有统计学意义（P＜0.05）。研究组的中位无进展生存期为3.9个月，高于对照组的2.8个月，差异有统计学意义（P＜0.05）。研究组的中位总生存期为6.1个月，与对照组的5.2个月比较，差异无统计学意义（P＞0.05）。研究组中的不良反应主要为粒细胞减少、消化道反应及头痛、头晕，均为Ⅰ～Ⅱ级，两组的不良反应发生率比较，差异无统计学意义（P＞0.05），所有不良反应经对症支持治疗后未影响放疗进行。结论全脑同步放疗联合替莫唑胺治疗NSCLC脑转移瘤近期有效率高，且能延长无进展生存期，不良反应少，患者耐受性良好。

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	万林林
	刘小红
	陈凯

关键词 ：非小细胞肺癌, 脑转移瘤, 全脑放疗, 替莫唑胺

Abstract：Objective To observe the efficacy and side effects of whole brain radiotherapy Combined with Temozolomide in the treatment of brain metastases of non-small cell lung cancer(NSCLC).Methods A total of 56 patients with NSCLC in our hospital from May 2014 to May 2017 were selected as the study objects.According to the random grouping method,all the patients were divided into the study group and the control group,with 28 cases in each group.The study group received whole brain radiotherapy combined with Temozolomide Capsules chemotherapy,whole brain radiotherapy dose was 40 GY/20 F,Temozolomide dose was 75 mg/(m2·d).The control group was treated with simple whole brain radiotherapy,and the dose and method of radiotherapy were the same as those of the study group.The treatment related adverse reactions were compared between the two groups during the treatment and after the end of the treatment.After 1 month at the end of the radiotherapy,the brain enhanced MRI was reviewed,and the total effective rate (RR),the progression free survival period and the total survival period were compared between the two groups.Results The total effective rate (RR)of the study group was higher than that of the control group,with significant difference (P＜0.05).The median progression free survival of the study group was 3.9 months,which was higher than that of the control group for 2.8 months,and the difference was statistically significant(P＜0.05).The median overall survival of the study group was 6.1 months,which was 5.2 months in the control group,there was no significant difference between the two groups(P＞0.05).In the study group of adverse reactions,most of them were granulocytic,digestive tract reaction and headache and dizziness,all of which were gradeⅠ toⅡ.There was no significant difference in the incidence of adverse reactions between the two groups (P＞0.05).All adverse reactions did not affect radiotherapy after symptomatic treatment.Conclusion whole brain radiotherapy combined with Temozolomide in the treatment of NSCLC brain metastases is highly effective in the near future,and can prolong the progression free survival,the adverse reaction is small,and the patient is well tolerated.

Key words： Non-small cell lung cancer Brain metastases Whole brain radiotherapy Temozolomide

引用本文:

万林林;刘小红;陈凯. 全脑放疗联合替莫唑胺治疗非小细胞肺癌脑转移瘤的效果评价[J]. 中国当代医药, 2018, 25(29): 61-63转72.
WAN Lin-lin;LIU Xiao-hong;CHEN Kai. Evaluation on the effect of whole brain radiotherapy combined with Temozolomide in the treatment of brain metastases of non-small cell lung cancer. 中国当代医药, 2018, 25(29): 61-63转72.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2018/V25/I29/61

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