CAJ | 학술논문

目的探讨全身化疗同步脑放疗或序贯脑放疗治疗非小细胞肺癌(NSCLC)脑转移患者的疗效和毒副反应.方法采用前瞻对照方法,将60例NSCLC脑转移患者分为全身化疗同步脑放疗组(同步组)和全身化疗序贯脑放疗组(序贯组),每组各30例.结果共59例患者完成治疗,总体客观缓解率(ORR)为22.0%,脑转移灶的ORR为35.6%,中位无进展生存期(PFS)为3个月,中位生存期(MST)为16个月,1年和2年总生存率分别为55.0%和24.4%.同步组和序贯组的总体ORR分别为20.0%和24.1%,脑转移灶的ORR分别为43.3%和27.6%,中位PFS分别为3和4个月,MST分别为16和13个月,差异均无统计学意义(均P>0.05).同步组和序贯组的1年生存率分别为58.5%和52.9%(P=0.365),2年生存率分别为37.2%和18.9%,同步组明显优于序贯组(P=0.011).同步组白细胞减少的发生率低于序贯组,差异有统计学意义(P=0.029);其他毒副反应的发生率差异无统计学意义(P>0.05).结论全身化疗同步脑放疗治疗NSCLC脑转移可以取得较好疗效,且患者耐受性良好.
목적 탐토전신화료동보뇌방료혹서관뇌방료치료비소세포폐암(NSCLC)뇌전이환자적료효화독부반응.방법 채용전첨대조방법,장60례NSCLC뇌전이환자분위전신화료동보뇌방료조(동보조)화전신화료서관뇌방료조(서관조),매조각30례.결과 공59례환자완성치료,총체객관완해솔(ORR)위22.0%,뇌전이조적ORR위35.6%,중위무진전생존기(PFS)위3개월,중위생존기(MST)위16개월,1년화2년총생존솔분별위55.0%화24.4%.동보조화서관조적총체ORR분별위20.0%화24.1%,뇌전이조적ORR분별위43.3%화27.6%,중위PFS분별위3화4개월,MST분별위16화13개월,차이균무통계학의의(균P>0.05).동보조화서관조적1년생존솔분별위58.5%화52.9%(P=0.365),2년생존솔분별위37.2%화18.9%,동보조명현우우서관조(P=0.011).동보조백세포감소적발생솔저우서관조,차이유통계학의의(P=0.029);기타독부반응적발생솔차이무통계학의의(P>0.05).결론 전신화료동보뇌방료치료NSCLC뇌전이가이취득교호료효,차환자내수성량호.
Objective To evaluate the efficacy, survival and toxicity in patients with brain metastases from non-small cell lung cancer ( NSCLC), treated with concurrent systemic chemotherapy and whole brain radiation therapy (WBRT) or sequential systemic chemotherapy/WBRT.Methods A total of 60 NSCLC patients with brain metastases were divided into two groups in this prospective clinical study:concurrent systemic chemotherapy and WBRT group (concurrent group ) and sequential systemic chemotherapy/WBRT group (sequential group).Results Of 59 assessable patients, the overall response rate was 22.0%, and the brain response rate was 35.6%;the median progression-free survival time was 3.0 months, and the overall 1- and 2-year survival rates were 55% and 24.4%, respectively, with a median survival time of 16.0 months.The overall response rate was 20.0% in the concurrent group and 24.1% in sequential group (P > 0.05 ).The brain response rates of 43.3% in concurrent group and 27.6% in sequential group were also not significantly different (P > 0.05 ).The median progression-free survival time for the patients in the concurrent group was 3.0 months versus 4.0 months in the sequential group, and the median survival time was 16.0 months versus 13.0 months ( all P >0.05 ).The 1- and 2-year survival rates were 58.5% and 37.2% versus 52.9% and 18.9%, respectively, with a significant difference in the 2-year survival rate between the two groups ( P = 0.011 ).In the sequential group, leukopenia was more frequent during chemotherapy than that in the concurrent group ( P = 0.029).Conclusion Concurrent systemic chemotherapy and WBRT is effective with tolerable adverse events in treating brain metastasis from NSCLC with an encouraging survival, and deserves further large sample and randomized multicenter clinical trials.