全脑放疗同步或序贯替尼泊甙、顺铂治疗小细胞肺癌脑转移

摘要

Objective: The aim of the study was to compare efficacies and safeties of 2 different treatments of whole brain radiotherapy (WBRT) sequential or concomitant Vm26/DDP for small cell lung cancer (SCLC) patients with brain metastases. Methods: A total of 39 patients were randomly divided into sequential chemoradiotherapy regime (A group, 20 patients) and concomitant chemoradiotherapy regime (B group, 19 patients). The dose of WBRT was 36 Gy in 18–20 fractions, chemotherapy of Vm26/DDP regimen with teniposide 60 mg/m2 on d1 to d3 and cisplatin 20 mg/m2 on d1 to d5, repeating every 3 weeks. The response was evaluated after WBRT and 2 cycles of chemotherapy. Results: Total response rates of A and B groups were 70.0% and 78.9% respectively (P = 0.520). The median survival was 11 months in A group and 10 months in B group. Six, twelve and eighteen months cumulative survival rates of A and B groups were 75.0%, 42.5%, 26.2%, and 81.6%, 26.4%, 10.5%, respectively (χ2 = 0.383, P > 0.05). Response rate and the number of brain metastases were independent prognostic factors. Conclusion: Both sequential and concomitant chemoradiotherapy groups are effective, and the main toxicity with myelosuppression is tolerable after therapy. It can be applied firstly and effectively to the SCLC patients with brain metastases in clinic .