国际肿瘤学杂志

国际肿瘤学杂志 ›› 2018, Vol. 45 ›› Issue (4): 202-205.doi: 10.3760/cma.j.issn.1673-422X.2018.04.003

• 论著 • 上一篇    下一篇

埃克替尼联合放疗治疗非小细胞肺癌脑转移的疗效观察

郝志强,于德东,杨海祥,张润平,朱巍   

  1. 014040 包头市中心医院肿瘤科 包头医学院肿瘤防治研究所
  • 出版日期:2018-04-08 发布日期:2018-05-16
  • 通讯作者: 朱巍，Email: 18686111667@163.com E-mail:18686111667@163.com
  • 基金资助:

    包头市科技局社会发展科技支撑（2013S2006-04-09）

Curative effects of icotinib combined with radiotherapy in non-small cell lung cancer with brain metastasis

Hao Zhiqiang, Yu Dedong, Yang Haixiang, Zhang Runping, Zhu Wei   

  1. Department of Oncology, Baotou Central Hospital; Institute of Oncology, Baotou Medical College, Baotou 014040, China
  • Online:2018-04-08 Published:2018-05-16
  • Contact: hu Wei, Email: 18686111667@163.com E-mail:18686111667@163.com
  • Supported by:

    Supportive Project of Social Development Technology in Baotou Science and Technology Bureau (2013S2006-04-09)

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摘要： 目的 探讨非小细胞肺癌(NSCLC)脑转移应用埃克替尼片联合全脑放疗（WBRT）的临床疗效和安全性。方法 选取包头市中心医院2010年10月至2015年4月收治的不能耐受化疗或化疗失败的NSCLC脑转移患者53例，按随机数字表法分为观察组（27例）和对照组（26例），脱落病例2例，观察组和对照组各1例,对照组予以WBRT（30 Gy/15 Fx），观察组在此基础上加服埃克替尼片125mg，3次/d。WBRT结束后随访18个月，比较两组患者不良反应、临床疗效及中位生存时间。结果 观察组患者的客观缓解率为88.5%，高于对照组的64.0%，差异有统计学意义（χ2=4.238，P=0.040）。观察组患者皮疹、肝功能损害发生率分别为76.9%、15.4%，高于对照组（均为0，χ2=31.638，P＜0.001；χ2=4.173，P=0.041)，但是多为Ⅰ～Ⅱ度，可耐受；两组患者治疗期间骨髓抑制、胃肠道反应发生率差异无统计学意义(26.9%∶20.0%，χ2=0.339，P=0.560；34.6%∶28.0%，χ2=0.259，P=0.611）。观察组患者中位生存时间（9.0个月）长于对照组（7.0个月）；观察组患者1年生存率（33.3%）高于对照组（23.1%），但是差异无统计学意义(χ2=0.676，P=0.411)。结论 埃克替尼片联合WBRT治疗NSCLC脑转移能明显提高脑转移瘤近期疗效，且有生存优势，不良反应可耐受。

关键词: 放射疗法, 癌, 非小细胞肺, 埃克替尼, 脑转移瘤

Abstract: Objective To study the clinical efficacy and safety of icotinib hydrochloride tablets combined with whole brain radiotherapy (WBRT) in non-small cell lung cancer (NSCLC) brain metastasis. Methods Fifty-three  patients with NSCLC brain metastasis who were unable to tolerate chemotherapy or che-motherapy failed were selected in Baotou Central Hospital from October 2010 to April 2015. The patients were divided into the observation group (n=27) and the control group (n=26) using random number table method. Two patients were dropped out, one in the control group and one in the observation group. The patients in the control group were given WBRT (30 Gy/15 Fx). On this basis, the patients in the observation group were given icotinib hydrochloride tablets 125 mg, 3 times a day. The patients were followed up for 18 months after the end of WBRT. The adverse reactions, clinical efficacy and the median survival times of the two groups were compared. Results The objective response rate of the observation group was 88.5%,  which was higher than that of the control group (64.0%), and the difference was statistically significant (χ2=4.238, P=0.040). The incidence rates of skin rash and liver function damage in the observation group were 76.9% and 15.4%, which were higher than those in the control group (0, χ2=31.638, P＜0.001; χ2=4.173, P=0.041). However, most of them were degree Ⅰ-Ⅱ, and they were tolerable. There were no significant differences in the incidence of myelosuppression and gastrointestinal reactions between the two groups (26.9% vs. 20.0%, χ2=0.339, P=0.560; 34.6% vs. 28.0%, χ2=0.259, P=0.611). The median survival time in the observation group (9.0 months) was longer than that in the control group (7.0 months). The one year survival rate of the observation group was 33.3%, which was higher than that of the control group (23.1%), but the difference was not significant (χ2=0.676, P=0.411). Conclusion Icotinib hydrochloride tablets combined with WBRT in the treatment of brain metastasis with NSCLC can significantly improve the curative effects of brain metastasis, and it has a survival advantage, with tolerable adverse reactions.

Key words: Radiotherapy, Carcinoma, non-small-cell lung, Icotinib, Brain metastasis