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目的观察表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor tyrosine kinase inhibitors,EGFR-TKI)联合放疗治疗非小细胞肺癌(non-small cell lung cancer,NSCLC)脑转移的治疗效果和不良反应。方法 EGFR基因突变的NSCLC脑转移患者104例随机分为观察组52例和对照组52例,对照组给予全脑放疗或立体定向放疗,观察组在对照组治疗基础上给予吉非替尼250mg/次或厄洛替尼150mg/次,1次/d,口服,至肿瘤进展或出现不能耐受的不良反应,比较2组客观缓解率、不良反应发生率及无进展生存期(progression free survival,PFS)。结果观察组客观缓解率为53.8%,中位PFS为8.8个月;对照组客观缓解率为30.8%,中位PFS为6.2个月,2组比较差异均有统计学意义(P<0.05);观察组皮疹、腹泻发生率高于对照组(P<0.05),2组恶心、呕吐、乏力、白细胞计数减少等发生率比较差异无统计学意义(P>0.05)。结论 EGFR-TKI联合放疗治疗NSCLC脑转移疗效满意,不良反应轻。
Objective To observe the therapeutic effects and adverse effects of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) combined with radiotherapy in the treatment of brain metastases of non-small cell lung cancer (NSCLC) reaction. Methods A total of 104 NSCLC patients with EGFR gene mutation were randomly divided into observation group (52 cases) and control group (52 cases). The control group received whole-brain radiotherapy or stereotactic radiotherapy. The observation group received gefitinib 250 mg / Or erlotinib 150mg / time, once / d, orally, to the progress of the tumor or intolerable adverse reactions, the two groups objective response rates, adverse reactions and progression free survival (progression free survival, PFS). Results The objective response rate was 53.8% in the observation group and 8.8 months in the median PFS. The objective response rate was 30.8% in the control group and the median PFS was 6.2 months. There was significant difference between the two groups (P <0.05). The incidence of rash and diarrhea in the observation group was higher than that in the control group (P <0.05). There was no significant difference in the incidence of nausea, vomiting, fatigue and white blood cell count between the two groups (P> 0.05). Conclusion EGFR-TKI combined with radiotherapy is effective in treatment of NSCLC brain metastases with mild adverse reactions.