摘要
目的探讨脑部放疗(RT)同步靶向治疗晚期驱动基因突变阳性非小细胞肺癌(NSCLC)合并脑转移(BM)患者的临床价值。方法回顾性分析安徽省肿瘤医院2017年1月至2020年7月收治的60例驱动基因突变阳性NSCLC合并BM患者的临床资料。根据治疗方案将其分为同步治疗组(32例,接受脑部RT同步靶向治疗);序贯治疗组(28例,接受脑部RT序贯靶向治疗)。比较两组近期疗效、不良反应发生率,采用Kalpan-Meier法评估生存情况。结果两组客观缓解率、不良反应发生率、中位总生存期(OS)比较,差异无统计学意义(P>0.05)。同步治疗组颅内疾病无进展生存时间(iPFS)高于序贯治疗组,差异有统计学意义(P<0.05)。亚组分析中,采用全脑放疗(WBRT)、局部RT、WBRT+局部RT的中位OS、中位iPFS比较,差异无统计学意义(P>0.05)。结论脑部RT同步靶向治疗驱动基因突变阳性NSCLC合并BM患者的不良反应可控,且可以提高患者iPFS。
Objective To investigate the clinical value of concurrent brain radiotherapy(RT)and targeted therapy for non-small cell lung cancer(NSCLC)with driver gene mutations positive combined with brain metastases(BM).Methods Clinical data of 60 NSCLC patients with driver gene mutations positive combined with BM who admitted to Anhui Provincial Cancer Hospital from January 2017 to July 2020 were retrospectively analyzed.According to the treatment plan,they were divided into the concurrent therapy group(32 cases,received concurrent brain RT and targeted therapy)and the sequential treatment group(28 cases,received brain RT and targeted therapy sequentially).Short-term efficacy and incidence of adverse reactions were compared between the two groups,and survival was assessed by Kalpan-Meier method.Results There were no statistically significant differences in the objective response rates,the incidence of adverse reactions and the median overall survival(OS)between the two groups(P>0.05).The intracranial progression free survival(iPFS)in the concurrent therapy group was higher than that in the sequential treatment group,and the difference was statistically significant(P<0.05).In the subgroup analysis,there were no significant differences in median OS and median iPFS between whole brain radiotherapy(WBRT),local RT,and WBRT+local RT(P>0.05).Conclusion The adverse reactions of NSCLC patients with driver gene mutations positive combined with BM can be controlled by concurrent brain RT and targeted therapy,and iPFS of patients can be improved.
作者
洪福
钱立庭
詹必红
张洪波
HONG Fu;QIAN Liting;ZHAN Bihong;ZHANG Hongbo(Department of Radiotherapy,Anhui Provincial Cancer Hospital,Anhui Province,Hefei230031,China;Department of Radiotherapy,the First Affiliated Hospital of University of Science and Technology of ChinaAnhui Provincial Hospital,Anhui Province,Hefei230001,China)
出处
《中国医药导报》
CAS
2021年第26期90-94,共5页
China Medical Herald
基金
科技部重点研发项目(2016YFB1000905)
吴阶平医学基金项目(320.6750.19094-31)。
关键词
非小细胞肺癌
脑转移
放疗
靶向治疗
Non-small cell lung cancer
Brain metastasis
Radiotherapy
Targeted therapy
