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目的分析埃克替尼联合全脑放疗治疗老年肺腺癌脑转移的疗效及不良反应。方法 57例肺腺癌脑转移患者,均为不能耐受化疗或不愿接受化疗的老年患者,根据治疗方法的不同分为靶向联合放疗组(27例)及单纯放疗组(30例)。观察并比较两组治疗有效率、中位生存时间、不良反应。结果靶向联合放疗组与单纯放疗组患者有效率(81.5%VS 40.0%)及疾病控制率(96.3%VS 73.3%)比较,差异均有统计学意义(P<0.05);靶向联合放疗组中位生存时间11个月,1年生存率51.9%;单纯放疗组中位生存时间7个月,1年生存率23.3%。两组1年生存率比较,差异有统计学意义(P=0.02<0.05)。靶向联合放疗组主要不良反应为皮疹,皮疹发生率为63.0%,有2例患者皮疹达4级,经对症处理,能耐受继续口服靶向药物。结论埃克替尼联合放疗治疗老年肺腺癌脑转移疗效好,不良反应少,值得临床推广应用。
Objective To analyze the efficacy and adverse reactions of icotinib combined with whole brain radiotherapy in the treatment of brain metastases from elderly patients with lung adenocarcinoma. Methods Totally 57 elderly patients with brain metastases of lung adenocarcinoma were eligible for chemotherapy or unwilling to receive chemotherapy. The patients were divided into radiotherapy group (n = 27) and radiotherapy group (n = 30) according to the treatment method. Observed and compared the two groups of treatment efficiency, median survival time, adverse reactions. Results Compared with the radiotherapy group and the radiotherapy alone group, the effective rate (81.5% VS 40.0%) and disease control rate (96.3% VS 73.3%) were significantly different (P <0.05) The median survival time was 11 months and the 1-year survival rate was 51.9%. The median survival time in radiotherapy alone group was 7 months and the 1-year survival rate was 23.3%. The 1-year survival rates of two groups were significantly different (P = 0.02 <0.05). The main side effects of the targeted combination radiotherapy were skin rashes, with a rash of 63.0% and rashes reaching grade 4 in 2 patients. After symptomatic treatment, they were able to tolerate continued oral targeting of the drug. Conclusion Icitinib combined with radiotherapy for the treatment of elderly patients with lung adenocarcinoma has good curative effect and few adverse reactions. It is worthy of clinical application.