吉非替尼与放疗联合替莫唑胺对无症状肺腺癌脑转移治疗的临床疗效

目的：观察吉非替尼单药与放疗联合替莫唑胺治疗肺腺癌伴脑转移的疗效与毒副反应.方法：40例患者随机分为吉非替尼组（Gefitinib组,20例）和放疗联合替莫唑胺组（R＋TMZ组,20例）.比较两组患者近期疗效、总生存期（OS）和毒副反应.结果：两组近期疗效无统计学差异（P＞0.05）.Gefitinib组中位生存期（OS） 15.5个月,R＋TMZ组10.8个月（P＜0.05）.Gefitinib组主要毒副反应为皮疹,R＋TMZ组主要毒副反应是恶心、呕吐.Gefitinib组生活质量高于R＋TMZ组（P＜0.05）.结论：吉非替尼与放疗联合替莫唑胺均可用于肺腺癌伴脑转移的治疗,但吉非替尼组治疗肺腺癌伴脑转移的近期疗效与放疗联合替莫唑胺组相当.吉菲替尼中位生存期优于放疗联合替莫唑胺.吉菲替尼组毒副反应轻微、生活质量明显改善.

Clinical efficacy of Gefitinib or radiotherapy plus Temozolomide in treatment of symptomatic lung adenocarcinoma with brain metastasis

Objective：To compare the efficacy and toxicities of Gefitinib monotherapy with radiotherapy plus temo zolomide in treatment of lung adenocarcinoma with brain metastases.Methods：All 40 patients were randomly enrolled into two groups：Gefitinib monotherapy group （Gefitinib） and radiotherapy plus temozolomide group （R ＋ TMZ）.We assessed the short-term effect,overall survival （OS） and toxicity of the two groups.Results：There were no significant differences between the two groups in the short-term effect （P ＞ 0.05）,and OS of the two group was 15.5 and 10.8 months,respectively （P ＜ 0.05）.The main adverse effects of Gefitinib group was rash,the major toxicities of R＋ TMZ group were nausea,vomiting.The QOL in Gefitinib group was superior than the R ＋ TMZ group （P ＜ 0.05）.Conclusion：Gefitinib monotherapy and radiotherapy plus temozolomide can be used in the treatment in lung adenocarcinoma with brain metastases.But the short-term effect of Gefitinib is not superior to radiotherapy plus temozolomide group in treatment of lung adenocarcinoma with brain metastases,and the median survival time of Gefitinib group is superior to radiotherapy plus temozolomide group.The toxicity of Gefitinib group was mild,and the QOL of Gefitinib group was improved significantly.