摘要
背景与目的:非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的多发脑转移预后极差。全脑放射治疗(whole brain radiotherapy,WBRT)是标准治疗方法。大多数临床研究结果显示化疗对肺癌多发脑转移的疗效不佳。厄洛替尼(Erlotinib,TARCEVA)是表皮生长因子受体的酪氨酸激酶抑制剂,用于NSCLC的治疗,本研究目的在于探讨WBRT同期联合厄洛替尼治疗NSCLC患者多发脑转移的疗效与耐受性。方法:12例NSCLC患者伴有多发脑转移接受WBRT(40Gy/20次/4周)并同期口服厄洛替尼150mg,每日1次,共计28天。治疗结束后和每3个月一次进行临床疗效评价直至疾病进展。结果:总有效率100%,其中完全缓解率66.7%,部分缓解率33.3%。中位总生存时间10个月,中位疾病进展时间8个月。临床症状缓解率100%。3例(25%)出现1级皮疹,1例(8.3%)发生轻度腹泻。结论:厄洛替尼同期联合WBRT治疗NSCLC多发脑转移有良好的近期治疗效果和耐受性。
BACKGROUND ＆ OBJECTIVE：Multiple brain metastases （MBM） considerably worsen the prognosis of non-small cell lung cancer （NSCLC） patients. Whole brain radiation therapy（WBRT） has been considered as the standard treatment for MBM. Unfortunately, the effectiveness of chemotherapy remains uncertain in this indication. Erlotinib （Tarceva） is an orally available HER1 （epidermal growth factor receptor, EGFR） tyrosine kinase inhibitor advancing through clinical trials for the treatment of NSCLC patients. This study aims to determine the efficacy and tolerability of Erlotinib concomitan t with WBRT for NSCLC patients with MBM. METHODS： Twelve NSCLC patients with MBM received conventional WBRT of 40Gy concurrently with Erlotinib 150 mg /day for 28 days. RESULTS： Overall objective responses were achieved in all the patients（100%） with 8 complete response （66.7%） and 4 patial response（33.3%）. Overall median survival was 10 months. Median time to progression was 8 months. Three patients （25%） presented a grade 1 rash and one patients （8.3%） experienced grade 1 diarrhea. CONCLUSION： The preliminary results demonstrated a good efficacy and tolerance of Erlotinib concomitant with WBRT for NSCLC patients with MBM. These data suggest that Erlotinib concomitant with WBRT could be a strategy worthy of further clinical trial.
出处
《中国神经肿瘤杂志》
2007年第3期180-182,共3页
Chinese Journal of Neuro-Oncology
