厄洛替尼联合放疗在肺腺癌脑转移中的疗效观察

目的观察厄洛替尼联合脑部放疗在肺腺癌患者中的疗效、不良反应和生存率。方法回顾性分析我院2008年1月-2011年1月113例EGFR敏感突变的肺癌腺癌脑转移患者,比较单纯口服厄洛替尼药物治疗(A组)、单纯接受脑部放疗(B组)、联合厄洛替尼口服及脑部放疗(C组)三种治疗方法患者的骨髓抑制程度、胃肠道反应、皮疹程度、中位生存期、以及1年、2年、3年生存率。结果所有研究对象至治疗第3月末复查头颅MRI或全身PET/CT检查评价疗效,A组为:CR 2例、PR 14例;1年、2年、3年生存率为39.5%、23.2%、18.6%;中位生存期14.5月;B组为:CR 4例、PR 15例;1年、2年、3年生存率为47.4%、26.3%、5.3%;中位生存期11月;C组为:CR 4例、PR 14例;1年、2年、3年生存率为50%、31.3%、18.8%;中位生存期18.5月;各组主要不良反应为骨髓抑制、恶心呕吐、腹泻、皮疹,均在可控制范围。C组同A、B组比较,除中位生存期明显延长外(P0.05、P0.01),其余指标无明显变化,具有统计学意义。结论厄洛替尼联合放疗治疗EGFR敏感突变的肺腺癌脑转移患者可明显延长生存期,改善生活质量,且毒副反应轻。

Curative effect of Erlotinib combined with radiotherapy on brain metastases from lung adenocarcinoma

Objective To observe the efficacy, adverse reaction and survival rate of Erlotinib combined with radiotherapy in brain metastases from lung adenocarcinoma. Methods A retrospective analysis was conducted on 113 cases of sensitive EGFR mutations in lung cancer patients with brain metastases from January 2008 to January 2011. The degree of bone marrow suppression, gastrointestinal reactions, rash, median survival and 1-year, 2-year and 3-year survival rate in the group A ( simple oral erlotinib therapy) , the group B ( brain radiotherapy alone) , and the group C ( joint Erlotinib orally and brain radiotherapy) . Results Their efficacy was evaluated by head MRI or whole body PET/CT examination at the end of the third month. In the group A, there were 2 cases of CR and 14 ca-ses of PR. The survival rate of 1-year, 2-year and 3-year was 39. 5%, 23. 2% and 18. 6%, respectively, and the median survival time was 14. 5 months. In the group B, there were 4 cases of CR and 15 cases of PR. The survival rate of 1-year, 2-year and 3-year was 47. 4%, 26. 3% and 5. 3%, and the median survival time was 11 months. In the group C, there were 4 cases of CR and 14 cases of PR. The survival rate of 1-year, 2-year and 3-year was 50%, 31. 3% and 18. 8%, and the median survival time was 18. 5 months. The main adverse reactions were bone marrow suppression, nausea and vomiting, diarrhea, rash in all groups, but in the acceptable range. The median survival pe-riod was prolonged evidently in the group C (P<0. 05). Conclusion Erlotinib combined with radiotherapy on sen-sitive EGFR mutations in lung adenocarcinoma with brain metastases can significantly prolong the survival time, im-prove the quality of life, and light toxic reaction.