广东医学
廣東醫學
엄동의학
GUNAGDONG MEDICAL JOURNAL
2015年
8期
1186-1189
,共4页
刘松然%邱波%陈丽昆%王芳%梁颖%蔡培强%张力%陈昭琳%刘孟忠%刘慧
劉鬆然%邱波%陳麗昆%王芳%樑穎%蔡培彊%張力%陳昭琳%劉孟忠%劉慧
류송연%구파%진려곤%왕방%량영%채배강%장력%진소림%류맹충%류혜
非小细胞肺癌%脑转移%放射疗法%表皮生长因子
非小細胞肺癌%腦轉移%放射療法%錶皮生長因子
비소세포폐암%뇌전이%방사요법%표피생장인자
non-small cell lung cancer%brain metastases%radiotherapy%epidermal growth factor
目的：探讨表皮生长因子受体（ EGFR）突变阳性、无症状脑转移的非小细胞肺癌（ NSCLC）患者脑部放疗（ BRT）的最佳时机。方法选取50例初诊无症状脑转移的EGFR突变阳性的肺腺癌患者，分析其治疗方案、疗效以及失败模式。结果50例患者的中位随访时间为26个月，2年总生存率为44.0％，预期生存时间为21个月。单因素分析显示ECOG评分、颅外转移灶、一线全身治疗方案与总生存期显著相关。多因素分析显示仅颅外转移灶与总生存期相关。所有患者2年脑转移无进展生存率为29.3％，预期时间为19个月。 BRT时机与脑转移无进展生存时间无明显相关性。结论对于无症状脑转移的EGFR突变阳性的NSCLC患者，一线BRT无明显生存获益，一线应用酪氨酸激酶抑制剂基础上延迟BRT可能是较好的治疗选择。
目的：探討錶皮生長因子受體（ EGFR）突變暘性、無癥狀腦轉移的非小細胞肺癌（ NSCLC）患者腦部放療（ BRT）的最佳時機。方法選取50例初診無癥狀腦轉移的EGFR突變暘性的肺腺癌患者，分析其治療方案、療效以及失敗模式。結果50例患者的中位隨訪時間為26箇月，2年總生存率為44.0％，預期生存時間為21箇月。單因素分析顯示ECOG評分、顱外轉移竈、一線全身治療方案與總生存期顯著相關。多因素分析顯示僅顱外轉移竈與總生存期相關。所有患者2年腦轉移無進展生存率為29.3％，預期時間為19箇月。 BRT時機與腦轉移無進展生存時間無明顯相關性。結論對于無癥狀腦轉移的EGFR突變暘性的NSCLC患者，一線BRT無明顯生存穫益，一線應用酪氨痠激酶抑製劑基礎上延遲BRT可能是較好的治療選擇。
목적：탐토표피생장인자수체（ EGFR）돌변양성、무증상뇌전이적비소세포폐암（ NSCLC）환자뇌부방료（ BRT）적최가시궤。방법선취50례초진무증상뇌전이적EGFR돌변양성적폐선암환자，분석기치료방안、료효이급실패모식。결과50례환자적중위수방시간위26개월，2년총생존솔위44.0％，예기생존시간위21개월。단인소분석현시ECOG평분、로외전이조、일선전신치료방안여총생존기현저상관。다인소분석현시부로외전이조여총생존기상관。소유환자2년뇌전이무진전생존솔위29.3％，예기시간위19개월。 BRT시궤여뇌전이무진전생존시간무명현상관성。결론대우무증상뇌전이적EGFR돌변양성적NSCLC환자，일선BRT무명현생존획익，일선응용락안산격매억제제기출상연지BRT가능시교호적치료선택。
Objective To assess the efficacy and appropriate timing of brain radiotherapy administration for asymptomatic brain metastasis (BM) in patients with epidermal growth factor receptor (EGFR) mutant non-small cell lung cancer ( NSCLC) .Methods Fifty patients diagnosed as EGFR mutant NSCLC with untreated asymptomatic BM were selected to analyze the treatment outcomes and failure patterns.Results With a median follow-up of 26 months, the 2-year overall survival ( OS) rate was 44.0% and the estimated OS time was 21 months.On univariate analysis, ECOG performance status, other distant metastases and first line systemic treatment were independently associated with OS.The successional multivariate analysis identified only other sites of distant metastases as the prognostic factor.The 2-year brain metastases progression free survival ( BM PFS) rate was 29.3%and the estimated time was 19 months.Wheth-er or not receiving the first-line brain radiotherapy( RT) didn′t show significant association with BM PFS.Conclusions First-line brain RT doesn′t improve OS of this cohort of patients, nor improve BM PFS.The status of systemic disease is the strongest prognostic factor.In treatment-naive NSCLC patients with an EGFR mutation and asymptomatic BM, partic-ularly in those with active systemic disease, first-line tyrosine kinase inhibitor and delayed brain RT may be proper.
