| 董明新,赵彤,黄京子,余淑坤,冯燕,田中成,金香顺,全吉钟,刘金,王冬旭.非小细胞肺癌脑转移瘤治疗方案的优化选择[J].中华放射医学与防护杂志,2006,26(4):371-373 |
| 非小细胞肺癌脑转移瘤治疗方案的优化选择 |
| Selection of optimal treatment scheme for brain metastases of non-small cell lung cancer |
| 投稿时间：2006-01-08 |
| DOI： |
| 中文关键词: 脑转移瘤 Vm-26化疗 伽玛刀 |
| 英文关键词:Brain metastases Chemotherapy of Vm-26 Gamma knife |
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| 中文摘要: |
| 目的 优化选择非小细胞肺癌脑转移瘤的治疗方案。方法 72例均有病理学诊断的住院患者。随机分成3组。全颅外放疗组24例(Ⅰ组)。伽玛刀加全颅放疗组22例(Ⅱ组)。伽玛刀加全颅放疗联合Vm-26治疗组26例(Ⅲ组)。全脑外放疗中心剂量36～41Gy,常规分割4～5周完成。伽玛刀治疗以50%等中心剂量曲线严格覆盖肿瘤边缘,处方剂量16～25Gy,平均16Gy。化疗:于全颅放疗DT19-29Gy,2～3周后,加Vm-26化疗,60mg·m2·d-1,连用3d,21d为1周期,共用2个周期。化疗期间继续放疗。结果 Ⅰ、Ⅱ和Ⅲ组的中位生存时间分别为6.0(1.2～19.0)、9.2(4.4～30.0)和10.8(5.2～42.2)个月,1、2年生存率分别为34.6%和12.6%;62.2%和30.2%;70.8%和35.6%。结论 采用3种不同方法治疗非小细胞肺癌脑转移瘤,Ⅲ组在提高局部控制率、延长生存期上明显优于Ⅰ组和Ⅱ组,且毒副作用可耐受。 |
| 英文摘要: |
| Objective To select the optimal treatment scheme for brain metastases of non-small cell lung cancers (NSCLCs). Methods Seventy-two NSCLC cases diagnosesd by pathology with brain metastases were randomly classified into three groups, Group Ⅰ, 24 cases with whole brain conventional external fractioned irradiation of DT 36-41 Gy/4-5 w, Group Ⅱ, 22 cases with γ-knife treatment plus whole brain conventional external fractioned irradiation, and Group Ⅲ, 26 cases with γ-knife plus whole brain conventional external fractioned irradiation in combination with chemotherapy of Vm-26. The surrounding area of tumor was strictly covered with 50% para-central-dosal curve in γ-knife treatment (DT 16-25 Gy with a mean of 16 Gy). The mult-leaf collimator was selected according to the volume of tumors. Chemotherapy of Vm-26 (60 mg/m2 d1-3) was applied during the treatment with whole brain conventional external fractioned irradiation (DT 19-29 Gy/2-3 w), 21 days in a period, 2 periods in total. Results The median survival time was estimated to be 6.0 months (ranged from 1.2 to 19.0 months) in the Group Ⅰ, 9.2 months (4.4-30 months) in the Group Ⅱ, and 10.8 months (5.2-42.2 months) in the Group Ⅲ. The 1-year and 2-year survival rates were 34.6% and 12.6%, 62.2% and 30.2%, and 70.8% and 35.6% respectively in Group Ⅰ, Group Ⅱ, and Group Ⅲ, respectively. Conclusion For brain metastases of NSCLC, γ-knife plus whole brain conventional external fractioned irradiation combined with treatment of Vm-26 had a significantly beneficial influence on improvement of the local control and 1-year and 2-year survival. There was no complaint about the side-effects of the treatment. |
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