Background and objective The aim of this study is to evaluate the efficacy of selected arterial infusion chemotherapy in treating non-small cell lung cancer (NSCLC) with multiple brain metastases and corresponding factors to influencing prognosis. Methods From September 2008 to October 2011, a total of 31 patients of NSCLC with multiple brain metastases (≥2) received selected incranial, bronchial and corresponding target arterial infusion chemotherapy combined with EGFR-TKls. Interventional treatment was performed every four weeks, two-six cycles with synchronized or sequential targeted drugs (erlotinib, gefitinib or icotinib). Follow-up CT and MRI were regularly finished at interval of four weeks after two cycles of interventional treatment were finished or during taking targeted drugs in order to evaluate efficacy of the therapy. The procedure was stopped for the tumor disease was worse or the patient could not tolerate the toxity of drugs any longer. Results 31 patients was performed two to six cycles of interventional therapy, 3cydes at average. Response assessment showed that 5 (16.1%) patients got a complete response (CR), 7 (22.6%) had a partial response (PR), 11 (35.5%) had a stable disease (SD) and 8 (25.8%) had a progressive disease (PD). The objective response rate (ORR) was 38.7%, and the disease control rate was 74.2%. The median progression free survival (PFS) and overall survival (OS) were 13.1 months and 15.1 months. The 6-month survival rate, one-year survival rate and two-year survival rate were 79%, 61.1%, and 31.1%, respectively. The patients' OS and PFS were influenced by smoking state, tumor pathology, extracranial metastases, period of targeted drug taking and performance status, not by sex, age, before therapy and the total of brain metastases. Conclusion Selected arterial infusion chemo-therapy with targeted drugs is one of the most effective and safe treatment to NSCLC with multiple brain metastases. Smoking status, tumor pathology, extracranial metastases, targeted drug taking and performance status are corresponding the patient's prognosis.%背景与目的 本研究旨在回顾性分析选择性动脉灌注化疗联合赖氨酸激酶抑制剂( tyrosine kinase inhibitor,TKI)药物治疗非小细胞肺癌(non-small cell lung cancer,NSCLC)多发脑转移的临床疗效及预后相关因素.方法 自2008年9月-2011年10月共入组31例诊断明确的非小细胞肺癌经CT或MRI证实多发脑转移瘤(＞3个)的患者,行选择性颅内动脉、支气管动脉及相关靶动脉化疗药物灌注化疗2个-6个周期,每周期间隔4周,同步或后续联合厄洛替尼、吉非替尼或埃克替尼治疗.介入治疗2个周期或联合靶向治疗后每4周应用CT和MRI对肿瘤进行疗效评价,直至肿瘤进展或发生不可耐受性化疗药物不良反应.结果 31例患者平均行3个周期介入治疗,随访时间4个-40.9个月,完全缓解5例(16.1％),部分缓解7例(22.6％),疾病稳定11例(35.5％),疾病进展8例(25.8％).客观缓解率( objective response rate,ORR)为38.7％,疾病控制率(disease control rate,DCR)为74.2％.中位无进展生存期(progression free survival,PFS)为13.1个月,中位总生存期(overall survival,OS)为15.1个月.6个月的生存率为79％,1年生存率为61.1％,2年生存率为31.1％.分层分析显示PFS、OS与吸烟状态、病理类型、颅外转移情况、靶向药物应用时间、PS评分具有相关性；与性别、年龄、既往治疗情况、脑转移数目无明显相关.结论 选择性动脉灌注化疗联合靶向药物是治疗非小细胞肺癌多发脑转移安全有效的方法之一,吸烟状态、PS评分、肿瘤病理类型、颅外转移状况、靶向药物应用时间均可影响患者预后.
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