同步放化疗及序贯放化疗治疗非小细胞肺癌脑转移的疗效及生存质量分析

目的:探究非小细胞肺癌（NSCLC）合并脑转移的患者分别接受同步放化疗和序贯放化疗的近期临床疗效及2年内生存质量的差别。方法:对我院收治的60例非小细胞肺癌合并脑转移患者资料进行统计分析，接受同步放化疗33例，接受序贯放化疗27例。比较两组近期疗效、中位生存时间、不良反应和无疾病进展生存期（PFS）。结果:同步放化疗组与序贯放化疗组患者治疗总有效率分别为79%、56%，差异具有统计学意义（P＜0.05）；同步放化疗组中位生存时间和PFS均优于序贯放化疗组（P＜0.05）；同步放化疗组的不良反应发生率高于序贯放化疗组，但两者差异无统计学意义（P＞0.05）。结论:与序贯放化疗相比，同步放化疗可显著提高非小细胞肺癌合并脑转移患者的近期疗效，延长生存期且不会更多地影响患者生存质量。

Efficacy and survival quality of synchronous radiotherapy and chemotherapy in patients with non-small cell lung cancer

Objective:To investigate overall survival,safety and life qualities of chemotherapy with concurrent versus sequential radiotherapy for non-small cell lung cancer（NSCLC).Methods:Clinical data were retrospectively analysed on 60 NSCLC patients with brain metastasis,33 patients received whole brain radiotherapy with concomitant chemotherapy,and the other 27 patients received whole brain radiotherapy with sequential chemotherapy.The short-term efficacy,median survival time,adverse reaction and median PFS were compared between the two groups.Survival time was analysed between two groups with Kaplan-Meier method.Results:The disease control rate of radiotherapy with concomitant chemotherapy was significantly higher than that in concomitant chemoradiotherapy group（79% vs 56%，P＜0.05).Median survival time of chemotherapy with concurrent radiotherapy was 16.7 months,and group of chemotherapy with sequential radiotherapy was 12.3 months． The median survival time and PFS in concurrent chemotherapy and radiotherapy group were superior to those in radiotherapy with sequential chemotherapy group.The incidence of adverse reactions in concurrent chemotherapy and radiotherapy group was higher than that of radiotherapy with sequential chemotherapy group,but it is not statistically significant（P＞0.05).Conclusion:Compared with radiotherapy with sequential chemotherapy,concurrent radiotherapy and chemotherapy can significantly improve the short-term efficacy of non-small cell lung cancer patients with brain metastases and prolonged survival time.On the other hand,it will not affect the quality of life of patients more.