放化疗同步治疗肺癌脑转移38例临床分析

目的:观察长春瑞滨(NVB)、顺铂(DDP)加用卫萌(Vm-26)联合脑部放射治疗肺癌脑转移患者的疗效、不良反应和生存率。方法:Vm-260·1,静脉滴入,d1~d3;NVB25mg/m2,静脉滴入,d1、d8;DDP20mg/m2,静脉滴入,d1~d3;21d为1个周期,脑部放疗于第1个周期化疗开始后第5天开始,每次DT1·8~2·0Gy,1次/d,每周5次,1~2个病灶者全脑放疗DT40Gy后缩野追加至DT60Gy,≥3个转移灶者给予全颅放疗DT45Gy。结果:治疗后90%患者神经系统症状改善,对脑转移灶的客观有效率为71·1%(27/38),对肺原发灶的有效率为42·1%(16/38),主要不良反应为骨髓抑制和脱发,中位生存期11·01个月,1年生存率39·5%(15/38)。结论:同步放、化疗治疗肺癌脑转移患者有效率和生存率均较高,且患者耐受性好。肿瘤防治杂志,2005,12(19):1502-1504

Clinical anglysis of concomitant radiotherapy combined with chemotherapy in 38 cases brain metastases of lung cancer

OBJECTIVE:To investigate the therapeutic effect, toxicity, and survival of concurrent radiotherapy combined with NVB, DDP, and Vm-26 in lung cancer patients with brain metastases. METHODS: Vm-26 0.1 g iv drip d_1-d_3;NVB 25 mg/m~2 d_1,d_8 iv drip d_1,d_8;DDP 20 mg/m~2 iv drip d_1-d_3, every 21 d. Whole-brain radiotherapy (WBRT) was administered on day 5 of the first course of chemotherapy by using ~(60)Co at a dose of D_T1.8-2.0 Gy/d given in 5 fractions per week. Patients with 1-2 brain lesions received WBRT at a dose of D_T40 Gy and then small field to a total dose of D_T60 Gy. Patients with more than 2 brain lesions of received WBRT at a total dose of D_T45 Gy. RESULTS: The treatment improved neurological symptoms in 90% of the patients .The response rates to brain lesions and primary lesions were 71.1%(27/38) and 42.1%(16/38),respectively. The median survival time (MST) was 11.01 months; the 1-year survival rates was 39.5%(15/38). The major toxicities were marrow suppression and alopecia. CONCLUSION: Concurrent radio-chemotherapy can be safely preformed for the patients with brain metastases from lung cancer with a remarkable response rate and encouraging survival duration.