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目的观察埃克替尼同步放疗治疗老年非小细胞肺癌无症状脑转移患者的疗效和安全性。方法选择2011年10月—2013年10月收治的老年非小细胞肺癌无症状脑转移患者62例,随机分为两组,试验组32例,给予埃克替尼(125 mg,3次/d)直到疾病进展或出现严重不良反应,同步放疗,包括原发灶及转移灶,肺原发灶及肺内转移灶剂量36~60Gy,脑转移灶先行全脑放疗40Gy;对照组30例,单纯放疗,方案同前,放疗结束1个月后评价疗效和不良反应。结果 62例患者均可评价疗效,试验组和对照组有效率(RR)分别为78.1%和46.7%,中位进展时间分别为9.6个月和7.3个月,两组差异均有统计学意义(P<0.05),两组主要不良反应为白细胞减少、恶心呕吐、肝功能损害、腹泻,均可耐受,差异无统计学意义(P>0.05),但联合组皮疹明显高于对照组,差异有统计学意义(P<0.05)。结论埃克替尼同步放疗治疗老年非小细胞肺癌无症状脑转移患者的疗效优于单纯放疗,安全性高,值得进一步临床研究推广。
Objective To observe the efficacy and safety of imatinib synchrotron radiation in the treatment of asymptomatic brain metastases in elderly patients with non-small cell lung cancer. Methods Sixty-two elderly patients with non-small cell lung cancer asymptomatic brain metastasis who were admitted to our hospital from October 2011 to October 2013 were randomly divided into two groups. The experimental group was given iccareni (125 mg, 3 times a day ) Until the disease progression or serious adverse reactions, concurrent radiotherapy, including primary and metastatic lesions, primary lung and lung metastases dose 36 ~ 60Gy, brain metastases prior to whole brain radiotherapy 40Gy; control group of 30 patients, simple Radiotherapy, the same protocol, one month after the end of radiotherapy to evaluate the efficacy and adverse reactions. Results The curative effect was evaluated in 62 patients. The effective rate (RR) in trial group and control group were 78.1% and 46.7%, respectively, and the median progression time was 9.6 months and 7.3 months respectively. There were significant differences between the two groups P <0.05). The main adverse reactions in the two groups were leukopenia, nausea and vomiting, liver damage and diarrhea, and the difference was not statistically significant (P> 0.05). However, the rash in the combination group was significantly higher than that in the control group There was statistical significance (P <0.05). Conclusion The efficacy of Icotinib synchrotron radiation in the treatment of asymptomatic brain metastases in elderly patients with non-small cell lung cancer is superior to that of radiotherapy alone, which is safe and worthy of further clinical research.