酪氨酸激酶抑制剂抑制非小细胞肺癌脑转移

目的]评价酪氨酸激酶抑制剂（tyrosine kinase inhibitors,TKI）对控制脑转移的作用。方法]83例Ⅳ期（或复发）非小细胞肺癌（NSCLC）患者接受吉非替尼或厄洛替尼治疗,同期67例化疗患者作为对照,随访脑转移出现的时间和生存时间。结果]经中位11.4个月的随访,TKI组脑转移发生率低于化疗组（18.29%vs 35.38%,χ2=5.5,P=0.019）。TKI组中发生脑转移的中位时间为7.6个月（6.9~8.3个月）,明显长于单纯化疗组4.9个月（4.4~5.4个月）（χ2=15.6,P=0.001）。TKI组中位总生存时间为11.4个月（95%CI：10.3~12.6）,长于单纯化疗组的7.5个月（95%CI：6.6~8.5）（χ2=19.3,P〈0.001）。结论]TKI降低晚期NSCLC患者脑转移的风险,延长患者的生存时间。

Tyrosine Kinase Inhibitors Suppress Brain Metastases in Advanced Non-small Cell Lung Cancer

Purpose] To investigate the effect of tyrosine kinase inhibitors on brain metastasis in patients with advanced non-small cell lung cancer. Methods] Eighty-three patients with stageⅣ NSCLC treated with gefitinib or erlotinib and 67 patients treated with chemotherapy as control group were collected. The survival time and the time to brain metastasis were analyzed.Results]With a median follow-up of 11.4 months,the rate of brain metastasis in TKI group was lower than that in chemotherapy group（18.29% vs 35.38%,χ2=5.5,P=0.019）. The median time to brain metastasis in TKI group was 7.6 months（95%CI：6.9~8.3）,which was longer than that in chemotherapy group（4.9months,Log Rank χ2=15.6,P0.001）. The median overall survival time in TKI group was also longer than that in chemotherapy group（11.4 vs 7.5 months,χ2=19.3,P0.001）. Conclusions] TKI（gefitinib or erlotinib） treatment reduces risk of BM and prolongs survival in patients with advanced NSCLC.