厄洛替尼治疗全脑放疗后复发／进展的非小细胞肺癌脑转移的疗效观察

目的对全脑放疗后复发／进展的非小细胞谛癌脑转移患者应用厄洛替尼治疗的疗效及不良反应进行观察。方法回顾性分析30例全脑放疗后复发／进展的非小细胞肺癌脑转移患者的，隘床资料。全部患者均接受厄洛替尼150mg，日1次口服，2个月后评价疗效和不良反应。结果携带EGFR外显子19／21突变者12例，状态不详者18例。全部患者颅内转移病灶的疾病控制率为56．7％，部分缓解4例（13．3％），稳定13例（43．3％），其中突变组部分缓解3例，稳定7例；状态不详组，部分缓解1例，稳定6例。全部患者全身病变的疾病控制率为43.3％，部分缓解3例（10％），稳定10例（33.3％），其中突变组部分缓解2例，稳定7例；状态不详组，部分缓解1例，稳定3例。比较两组的有效率、疾病控制率，均有统计学意义（均P〈0．05）。主要不良反应包括乏力20例（66．7％）、皮疹14倒（46．7％）、腹泻6例（20％）等，多为I度或II度。突变组较状态不详组皮疹发生率差异有统计学意义（均P〈0．05）。结论厄洛替尼对于全脑放疗后复发／进展NSCLC脑转移患者治疗有效，对EGFR基因突变者疗效更好，不良反应较轻，耐受性好。

Effective Observation of Erlotinib for Recurrence/Progression in Patients with Non-small Cell Cancer with Brain Metastases after Whole Brain Radiotherapy

Objective To observe the antitumor efficacy and adverse reaction of erlotinib for recurrence/progression in patients with non-small cell （NSCLC） with brain metastases after whole brain radiotherapy. Methods The clinical data of 30 NSCLC patients with previously irradiated and recurrent/progressive brain metastases was analyzed retrospectively. They were treated orally with erlotinib at a daily dose of 150mg.The efficacy and adverse reaction was evaluated after 2 months. Resouts Twelve patients had EGFR gene exon 19/21 mutations and 18 patients with unknown EGFR mutational status. The overall disease control rate （DCR） for all patients with intracranial brain metastases was 56.7%, including 4 patients （13.3%）with patial response （PR） and 13 patients （43.3%） under stable disease （SD） condition. The PR and SD in the mutational group were 3 and 7 cases; those were 1 and 6 cases in the unspecified mutational group, respectively. As for systemic disease, DCR was 43.4% including PR in 3 patients （10%）, SD in I0 ones （33.3%）. The PR and SD inmutaional group was 2 and 7 cases, and which were 1 case and 3 cases in unspecified mutational group, respectively. Erlotinib showed significantly more effective in the mutational group than that in the unspecified mutational group （P〈0.05）. The major adverse reactions were grade 1/2 fatigue （66.7%）, skin rash and diarrhea with 46.7% and 20% respectively. The incidence of rash was conspicuously higher in mutational group than that in unspecified mutational group （P〈0.05）. Conclusion Erlotinib is effective and safe on treating NSCLC patients with previously irradiated, recurrent/progressive brain metastases, especially for those with EGFR mutations.