放疗联合替莫唑胺治疗非小细胞肺癌脑转移瘤的临床观察

目的 探讨放疗联合替莫唑胺治疗非小细胞肺癌(NSCLC)脑转移瘤的临床疗效及不良反应.方法 回顾性分析河北大学附属医院放疗科收治的NSCLC脑转移患者51例.按照治疗方法将患者分为实验组(n=26)和对照组(n=25),实验组采用全脑放疗及局部肿瘤缩野加量放疗+口服替莫唑胺,对照组仅采用全脑放疗及局部肿瘤缩野加量放疗,分析两组患者的临床疗效及不良反应.结果治疗后实验组的Karnofsky功能状态评分较对照组改善显著(76.2±6.4∶72.8±5.3),差异有统计学意义(t=2.06,P=0.04),实验组放疗的总有效率高于对照组(80.8%∶64.0%),但是差异无统计学意义(χ2=1.80,P=0.18).与对照组相比,实验组治疗期间恶心呕吐(80.8%∶28.0%)、骨髓抑制(84.6%∶24.0%)的发生率均明显升高,差异有统计学意义(χ2=14.33,P=0.00;χ2=18.91,P=0.00);两组患者在头痛(69.2%∶60.1%)、肝肾功能损害(73.1%∶64.0%)方面差异无统计学意义(χ2=0.47,P=0.49;χ2=0.47,P=0.49).结论 放疗联合替莫唑胺治疗NSCLC脑转移能够改善患者生命质量,且不良反应可控,患者可耐受.

Clinical observation of radiotherapy combined with temozolomide in non-small cell lung cancer patients with brain metastases

Objective To investigate the recent curative effect and adverse reactions of radiotherapy combined with temozolomide in non-small cell lung cancer (NSCLC) patients with brain metastases.MethodsThe clinical date of 51 NSCLC patients with brain metastases were retrospective analyzed in Department of Radiation Oncology of Affiliated Hospital of Hebei University.Patients were divided into experimental group (n=26) and control group (n=25) according to the different treatment methods.The experimental group underwent whole brain and local tumor radiotherapy plus temozolomide.The control group only received whole brain and local tumor radiotherapy.The recent curative effect and adverse reactions of the two groups were analyzed.Results The Karnofsky performance status score of patients in the experimental group was obviously improved than that in the control group (76.2±6.4 vs.72.8±5.3), with a significant difference (t=2.06, P=0.04).The total effective rate in the experimental group was higher than that in the control group (80.8% vs.64.0%), but there was no statistically significant difference (χ2=1.80, P=0.18).Compared with the control group, the incidences of nausea and vomiting (80.8% vs.28.0%) and bone marrow suppression (84.6% vs.24.0%) in the experimental group were significantly higher, with significant differences (χ2=14.33, P=0.00;χ2=18.91, P=0.00).There were similar incidences of headache (69.2% vs.60.1%), liver and kidney damage (73.1% vs.64.0%) in the two groups, with no significant differences (χ2=0.47, P=0.49;χ2=0.47, P=0.49).Conclusion Radiotherapy combined with temozolomide can improve the quality of life in NSCLC patients with brain metastases, which has controllable and tolerable adverse reactions.