厄洛替尼同步WBRT对EGFR突变阳性肺腺癌多发脑转移的临床疗效

目的 探讨厄洛替尼同步WBRT治疗肺腺癌多发脑转移的临床疗效和安全性,为改善患者预后提供客观依据。方法 选取我院肿瘤科收治的EGFR基因突变阳性肺腺癌脑转移患者89例,根据患者采用不同的脑转移治疗方法分为研究组45例和对照组44例,研究组给予厄洛替尼同步WBRT,对照组首先给予单纯口服厄洛替尼28 d后同时WBRT。采用Kaplan-Meier法计算生存率并Logrank法检验,余用χ²检验。结果 研究组脑转移灶的客观缓解率(78%)明显高于对照组(55%)(P=0.000)。研究组和对照组的中位PFS分别为9.1个月(95%CI为5.18~12.47)和5.6个月(95%CI为3.46~9.12)(P=0.078)。研究组和对照组的中位OS分别为14.3个月(95%CI为9.51~17.82)和9.7个月(95%CI为4.59~16.74)(P=0.032)。研究组患者头痛、头昏发生率明显高于对照组患者(38%∶14%,P=0.029;33%∶9%,P=0.020)。结论 厄洛替尼同步WBRT治疗EGFR突变阳性肺腺癌多发脑转移较单纯采用厄洛替尼具有更高的有效率,并延长了患者神经系统PFS和OS期。

Clinical efficacy of erlotinib combined with concurrent whole brain radiotherapy in treatment of multiple brain metastases from EGFR-mutant lung adenocarcinoma

Objective To investigate the clinical efficacy and safety of erlotinib combined with concurrent whole brain radiotherapy (WBRT) in the treatment of multiple brain metastases from lung adenocarcinoma, and to provide Objective evidence for improving the prognosis of patients. Methods Eighty-nine patients with brain metastases from epidermal growth factor receptor (EGFR)-mutant lung adenocarcinoma who were admitted to our hospital were divided into experimental group (n=45) and control group (n=44) according to the different treatment methods. The experimental group received erlotinib combined with concurrent WBRT. The control group received oral administration of erlotinib alone for 28 d and then received concurrent WBRT. The survival rates were calculated using the Kaplan-Meier method and analyzed using the log-rank test. The other data were analyzed by the chi-square test. Results The Objective response rate was significantly higher in the experimental group than in the control group (78% vs. 55%, P=0.000). The median progression-free survival (PFS) time in the experimental group and the control group were 9.1 months (95% confidence intervalCI]:5.18-12.47) and 5.6 months (95%CI:3.46-9.12), respectively (P=0.078). The median overall survival (OS) time in the experimental group and the control group were 14.3 months (95%CI:9.51-17.82) and 9.7 months (95%CI:4.59-16.74), respectively (P=0.032). The incidence rates of headache and dizziness were significantly higher in the experimental group than in the control group (38% vs. 14%, P=0.029;33% vs. 9%, P=0.020). Conclusions In the treatment of multiple brain metastases from EGFR-mutant lung adenocarcinoma, erlotinib combined with concurrent WBRT is superior to erlotinib alone. The combination therapy increases PFS and OS time of the nervous system in patients.