标题：埃克替尼联合放疗治疗EGFR突变型肺腺癌无症状脑转移疗效观察

      作者：罗鹏辉，王湘萍，莫敦昌，刘艳萍，黄昌杰    (广西医科大学第三附属医院肿瘤科，广西 南宁 530031)

      卷次： 2017年28卷8期

      【摘要】 目的 评价埃克替尼联合放疗在治疗EGFR突变型肺腺癌无症状脑转移患者中的作用。方法 回顾性分析2012年1月至2015年6月广西医科大学第三附属医院61例EGFR突变型肺腺癌无症状脑转移患者的临床资料，其中埃克替尼联合放疗(联合组) 23例，埃克替尼单药治疗(靶向治疗组) 38例。靶向治疗第1、3、5个月及之后每 3个月复查评价疗效。χ2检验评价两组客观缓解率、疾病控制率，Kaplan Meier法和Log-rank法进行生存分析。结果 在靶向治疗第5个月，联合组的总客观缓解率和总疾病控制率分别为82.6%和95.7%，均明显高于靶向治疗组的55.3%和76.3%，差异均有统计学意义(P<0.05)；联合组的脑转移瘤客观缓解率和疾病控制率分别为95.7%和100.0%，均明显高于靶向治疗组的55.3%和81.6%，差异均有统计学意义(P<0.05)；中位无进展生存时间联合组14个月，靶向治疗组8个月，差异亦有统计学意义(P<0.05)；Ⅲ~Ⅳ级毒副反应中，联合组疲乏、恶心、呕吐明显高于靶向治疗组，差异均有统计学意义(P<0.05)，但可耐受，皮疹、腹泻、骨髓抑制差异均无统计学意义(P>0.05)。结论 埃克替尼联合放疗明显提高EGFR突变型肺腺癌无症状脑转移患者的治疗效果，延长患者中位无进展生存时间，毒副反应可以耐受。
      【关键词】 肺癌；肺腺癌；脑转移；埃克替尼；放疗；靶向治疗
      【中图分类号】 R734.2 【文献标识码】 A 【文章编号】 1003—6350（2017）08—1219—04

Clinical effect of icotinib combined with radiotherapy for asymptomatic brain metastasis in patients withepidermal growth factor receptor mutant non-small cell lung cancer.
LUO Peng-hui, WANG Xiang-ping, MODun-chang, LIU Yan-ping, HUANG Chang-jie. Department of Oncology, the Third Affiliated Hospital of Guangxi MedicalUniversity, Nanning 530031, Guangxi, CHINA
【Abstract】 Objective To assess the efficacy of icotinib combined with radiotherapy for asymptomatic brainmetastasis (BM) in patients with epidermal growth factor receptor (EGFR) mutant non-small cell lung cancer (NSCLC).Methods Sixty-one patients diagnosed as EGFR mutant NSCLC with asymptomatic BM treated in the Third AffiliatedHospital of Guangxi Medical University from January 2012 to June 2015 were retrospectively reviewed. Twenty-three ofthem were treated with icotinib and brain radiotherapy (joint therapy group). Thirty-eight of them were treated with Ico-tinib only (targeting treatment group). The curative effect in target therapy after 1, 3, 5 months and every 3 months (in-cluding cranial MRI examination), and at the end of radiotherapy were evaluated. χ2 test between two groups was carriedout to evaluate the objective response rate (ORR), disease control rate (DCR), and the Kaplan Meier method and theLog-rank method were used for survival analysis. Results In the fifth month of targeted therapy, the overall ORR andDCR in the joint therapy group were 82.6% and 95.7%, which in the targeting treatment group were 55.3% and 76.3%,·论 著·doi:10.3969/j.issn.1003-6350.2017.08.005基金项目：广西科学研究与技术开发计划（编号：桂科攻14124004-1-21）