CAJ | 학술논문

目的探讨表皮生长因子受体(EGFR)酪氨酸激酶抑制剂厄洛替尼联合全脑放疗治疗非小细胞肺癌(NSCLC)脑转移的临床疗效及不良反应,评价其有效性和安全性.方法选取病理证实的出现脑转移的NSCLC患者63例,采用随机数字表法分为厄洛替尼联合全脑放疗组(33例)和单纯全脑放疗组(30例),所有患者均接受全脑放疗,肿瘤吸收剂量(3 000 ～3 600) cGy/(10 ～ 12)F,厄洛替尼联合全脑放疗组患者自放疗开始应用厄洛替尼150 mg,口服,1次/d,直至放疗完成后至少2个月.全组病例于放疗结束2个月时进行疗效评估.结果厄洛替尼联合全脑放疗组和单纯全脑放疗组转移灶客观有效率和疾病控制率分别为54.6％、13.3％(x2=11.744,P=0.001)和91.0％、60.0％(x2=8.276,P =0.004),差异有统计学意义.两组总体客观有效率和疾病控制率分别为39.3％、10.0％(x2=7.166,P =0.007)和84.8％、40.0％(x2=7.759,P=0.005).分层分析显示,厄洛替尼联合全脑放疗组中,EGFR突变阳性和阴性亚组的客观缓解率和疾病控制率分别为76.5％、33.3％(x2=6.248,P=0.012)和100％、77.7％(x2=4.093,P=0.043).厄洛替尼联合全脑放疗组1年生存率和无进展生存率分别为57.6％、42.4％,明显高于单纯全脑放疗组的30.0％、16.7％,差异均具有统计学意义(x2=4.840,P=0.028;x2=4.950,P=0.026).厄洛替尼联合全脑放疗组主要不良反应为皮疹、腹泻,均为轻中度,未发生治疗相关性死亡.结论厄洛替尼联合全脑放疗对NSCLC脑转移具有一定的疗效,且不良反应轻微,可以作为NSCLC脑转移的一种治疗选择.
목적 탐토표피생장인자수체(EGFR)락안산격매억제제액락체니연합전뇌방료치료비소세포폐암(NSCLC)뇌전이적림상료효급불량반응,평개기유효성화안전성.방법 선취병리증실적출현뇌전이적NSCLC환자63례,채용수궤수자표법분위액락체니연합전뇌방료조(33례)화단순전뇌방료조(30례),소유환자균접수전뇌방료,종류흡수제량(3 000 ～3 600) cGy/(10 ～ 12)F,액락체니연합전뇌방료조환자자방료개시응용액락체니150 mg,구복,1차/d,직지방료완성후지소2개월.전조병례우방료결속2개월시진행료효평고.결과 액락체니연합전뇌방료조화단순전뇌방료조전이조객관유효솔화질병공제솔분별위54.6％、13.3％(x2=11.744,P=0.001)화91.0％、60.0％(x2=8.276,P =0.004),차이유통계학의의.량조총체객관유효솔화질병공제솔분별위39.3％、10.0％(x2=7.166,P =0.007)화84.8％、40.0％(x2=7.759,P=0.005).분층분석현시,액락체니연합전뇌방료조중,EGFR돌변양성화음성아조적객관완해솔화질병공제솔분별위76.5％、33.3％(x2=6.248,P=0.012)화100％、77.7％(x2=4.093,P=0.043).액락체니연합전뇌방료조1년생존솔화무진전생존솔분별위57.6％、42.4％,명현고우단순전뇌방료조적30.0％、16.7％,차이균구유통계학의의(x2=4.840,P=0.028;x2=4.950,P=0.026).액락체니연합전뇌방료조주요불량반응위피진、복사,균위경중도,미발생치료상관성사망.결론 액락체니연합전뇌방료대NSCLC뇌전이구유일정적료효,차불량반응경미,가이작위NSCLC뇌전이적일충치료선택.
Objective To study clinical efficacy and toxicity of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor erlotinib combined with whole brain radiotherapy in the non-small cell lung cancer (NSCLC) with brain metastases and to evaluate its effectiveness and safety.Methods In accordance with the random digital number method, Sixty-three NSCLC patients with brain metastases were divided into erlotinib combined with whole brain radiation therapy group (33 cases) and whole brain radiotherapy alone group (30 cases), each patient received the whole brain radiotherapy, DT (3 000-3 600)cGy/(10-12) F.Erlotinib combined with whole brain radiotherapy group received oral erlotinib, at a dose of 150 mg per day from the beginning of the whole brain radiotherapy, at least two months until after the completion of radiation therapy.All patients were evaluated in the efficacy of radiotherapy at the end of two months.Results The metastases objective response rate and disease control rate of erlotinib combined with whole brain radiation therapy group and whole brain radiotherapy alone group were respectively 54.6％, 13.3％ (x2 =11.744, P =0.001) and 91.0％ , 60.0％ (x2 =8.276, P =0.004).The objective response rate and disease control rate in the two groups were respectively 39.3％, 10.0％ (x2 =7.166, P =0.007) and 84.8％, 40.0％ (x2 =7.759, P =0.005).Stratified analysis showed that in erlotinib combined with whole brain radiotherapy group, the objective response rate and disease control rate of EGFR mutation positive and negative subgroup were respectively 76.5％, 33.3％ (x2 =6.248, P=0.012) and 100％, 77.7％ (x2 =4.093, P=0.043).The 1-year sur vival and progression-free survival rates of the two groups were 57.6％, 30.0％ and 42.4％, 16.7％, the differences were statistically significant (x2 =4.840, P =0.028;x2 =4.950, P =0.026).The main adverse events of erlotinib combined with whole brain radiotherapy group were mild to moderate rash, diarrhea, and no treatment-related deaths occurred.Conclusion Erlotinib combined with whole brain radiotherapy for the NSCLC patients with brain metastases has some effect, and the adverse reactions are mild, which can be used as a treatment option for NSCLC brain metastases.