摘要
背景与目的脑放疗是非小细胞肺癌脑转移的传统治疗,化疗与脑放疗的联合是近年的研究方向。鉴于序贯/维持化疗近年来在晚期非小细胞肺癌显示较好前景,我们对非小细胞肺癌脑转移患者进行序贯化疗联合脑放射的治疗探索。方法对确诊的非小细胞肺癌脑转移患者采用TP-NP-GP三个方案序贯化疗联合同期的脑放射进行治疗。TP方案:TXT175mg/m2d1,DDP20mg/m2d1-5,每3周重复;NP方案:NVB25mg/m2d1、8,DDP20mg/m2d1-5,每3周重复;GP方案:GEM1g/m2d1、8,DDP20mg/m2d1-5,每3周重复。每个化疗方案至少使用2疗程,有效的患者继续原方案至4疗程后行下一个方案的序贯化疗。结果51例患者使用TP-NP-GP方案序贯化疗在外周病灶的有效率分别为41.2%、35.6%及27.8%,联合同期的脑放射治疗在脑转移灶的有效率达到60.8%。中位生存期14.7个月。1年、2年及3年生存率分别为67.8%、20.6%及1.3%。结论第三代新药方案序贯化疗联合脑放射治疗非小细胞肺癌脑转移可以取得较好疗效,总体耐受性良好。
Background and objective Brain irradiation is the traditional treatment for NSCLC patients with brain metastases, whereas combined with chemotherapy is the novadays treatment direction. Since sequential/maintenance chemotherapy has shown promising results in advanced NSCLC, we carried out the study to explore the role of sequential chemotherapy combined with brain radiotherapy in patients with brain metastases. Methods Treatment na/ve NSCLC patients with brain metastases sequentially received the 3 chemotherapy regimens TP-NP-GP. The TP regimen consisted of Paclitaxol 175 mg/m^2 dl, Cisplatin 20 mg/m^2 d1-5.The NP regimen consisted of Nevalbine 25 mg/m^2 dl and 8, Cisplatin 20 mg/m^2 d1-5. The GP regimen consisted of Gemcitabine 1 g/m^2 dl and 8, Cisplatin 20 mg/m^2 d1-5. All regimens were repeated every 3 weeks. Each regimen was executed for at least 2 cycles and no more than 4 cycles. Results The response rates ofTP, NP and GP sequentially used were 41.2%, 35.6% and 27.8% respectively for the out brain lesions and 60.8% for the brain lesions combining with brain irradiation. Median survival time was 14.7 months and the 1, 2 and 3 year overall survivals were 67.8%, 20.6% and 1.3% respectively： Conclusion The 3^rd generation regimen-based sequential chemotherapy combined with WBRT was effective for NSCLC patients with brain metastasis with an encouraging survival and acceptable tolerability.
出处
《中国肺癌杂志》
CAS
2009年第8期896-900,共5页
Chinese Journal of Lung Cancer
基金
广东省医学科研基金项目(No.B2006062)资助~~
关键词
脑转移癌
肺肿瘤
序贯化疗
脑放疗
Brain metastasis
Lung neoplasms
Sequential chemotherapy
Brain irradiation
