埃克替尼联合放疗治疗非小细胞肺癌脑转移的疗效及安全性探讨

夏云　王志

[摘要] 目的 探讨埃克替尼联合放疗治疗非小细胞肺癌（NSCLC）脑转移的疗效及安全性。 方法 选取2014年3月～2016年3月我院收治40例非小细胞肺癌（NSCLC）脑转移患者，分为观察组与对照组，每组20例。对照组采用地塞米松及甘露醇脱水治疗的同时，对患者行全脑放疗；观察组加以埃克替尼治疗，直到毒副反应不能耐受为止。在结束治疗之后，对比两组患者治疗效果及安全性。 结果 两组患者中，最短随访时间均为3个月。观察组有4例患者出现肿瘤进展而停止服药。在进行治疗干预之后，相较于对照组治疗总有效率75.00%，观察组为95.00%较为优异，差异有统计学意义（P<0.05）；转氨酶升高、骨髓抑制、呕吐、皮疹、腹泻，是出现于治疗期间的不良反应，且患者经治疗后均缓解。 结论 针对非小细胞肺癌（NSCLC）脑转移患者，采用埃克替尼联合放疗治疗，患者毒副反应大多可耐受，近期疗效较好，还需进一步观察对患者长期生存的影响，具有临床应用价值。

[关键词] 非小细胞肺癌脑转移；埃克替尼；放疗；安全性；治疗效果

[中图分类号] R734.2 [文献标识码] B [文章编号] 1673-9701（2017）36-0078-03

[Abstract] Objective To investigate the efficacy and safety of icotinib combined with radiotherapy in the treatment of non-small cell lung cancer （NSLC） brain metastases. Methods From March 2015 to March 2016， 40 patients with brain metastases induced by non-small cell lung cancer （NSLC） who were admitted to our hospital were selected and were divided into observation group and control group， with 20 cases in each group. The control group was given dexamethasone and mannitol for dehydration， and at the same time， the patients were given whole brain radiotherapy. Based on this， the observation group was further given icotinib until the toxic and adverse reactions were not tolerated. After the end of treatment， the efficacy and safety of the two groups were compared. Results In the two groups of patients， the shortest follow-up time was 3 months. 4 patients in the observation group showed tumor progression and thus withdrew from taking medicine. After treatment intervention， compared with the the total effective rate of 75.00% in the control group， the total effective rate was 95.00% in the observation group， which was more excellent. The difference was statistically significant（P<0.05）； increased aminotransferases， myelosuppression， nausea， vomiting， rash， diarrhea were the adverse reactions that occurred during treatment， and patients were relieved after treatment. Conclusion For the patients with brain metastasis induced by non-small cell lung cancer （NSLC）， patients undergoing the combination of icitinib and radiotherapy can tolerate most of the toxic and adverse effects， and the short-term efficacy is favorable. However， further observation is in need to observe the impact on long-term survival of patients. The method is of clinical application value.

[Key words] Non-small cell lung cancer （NSLC） brain metastases； Icotinib； Radiotherapy； Safety； Therapeutic effect

继吉非替尼及厄洛替尼之后的，国际上第三个，以及我国第一个EGFR-TKI药物，便是盐酸埃克替尼[1]。在晚期NSCLC中，能显著降低不良反应，疗效与吉非替尼相当，在對我国晚期 NSCLC 治疗中，其已经成为标准化药物之一[2]。在全国各种癌症中，肺癌为有关死亡之首，且肺癌患者致死及治疗失败的重要原因之一，是肺癌脑转移，且近些年的发病率逐渐升高，当前首要的治疗方式是全脑放疗[3]。但是，针对于非小细胞肺癌脑转移患者，埃克替尼联合放疗治疗的安全性及疗效，在国内有较少有关报道，所以循证医学依据，在临床应用中较为短缺[4]。本研究通过对非小细胞肺癌（NSCLC）脑转移患者，采用埃克替尼联合放疗治疗，现报道结果如下。

1 资料与方法