全脑放疗联合替莫唑胺治疗肺癌脑转移疗效观察

目的:探讨全脑放疗（WBRT）联合替莫唑胺（TMZ）治疗非小细胞肺癌（NSCLC）脑转移的疗效。方法:回顾分析本院2010年-2014年收治的37例接受WBRT联合TMZ同步治疗及TMZ辅助治疗的NSCLC脑转移患者疗效。WBRT剂量30Gy，TMZ放疗同步口服75mg/(m2·d)，序贯给予TMZ 150~200mg/(m2·d)，连续5天，28天为1周期，3~6周期。结果:完全缓解10.8%(4/37)，部分缓解40.5%(15/37)。中位无进展生存时间和中位生存时间分别为8和10个月。最常见不良反应恶心、呕吐，中性粒细胞减少和血小板减少的发生率分别为59.5%（22/37），32.4%（12/37），35.1%（13/37）。结论:WBRT联合TMZ同步治疗及TMZ辅助化疗治疗NSCLC脑转移癌安全有效，耐受性良好，不良反应轻，可作为脑转移癌放化疗综合治疗模式之一进行深入研究。

Study of temozolomide and whole-brain radiotherapy for non-small cell lung cancer patients with brain metastases

Objective:To analyze the treatment outcome and prognosis of non-small cell lung cancer（NSCLC) patients with brain metastases（BM) treated by temozolomide（TMZ) and whole-brain radiotherapy（WBRT).Methods:From 2010 to 2014，thirty seven NSCLC with BM received 30Gy WBRT with concomitant TMZ 75mg/(m2·d) for ten days，followed by TMZ 150~200mg/(m2·d) for 5 days every 28 days，up to six cycles.Results:Four complete responses（10.8%) and 15 partial responses（40.5%) were achieved.The overall median survival was 10 months and the median progression-free survival was 8 months.The regimen appeared to be well tolerated，the most frequent toxicities included nausea and vomiting（59.5%，22/37)，neutropenia（32.4%，12/37)，thrombocytopenia（35.1%，13/37).Conclusion:This study shows an encouraging objective response rate of brain metastases.The concomitant use of WBRT and TMZ with adjuvant TMZ chemotherapy appears to be an active，well-tolerated regimen.The study also suggests the need for further investigation of the regimen compared with others.