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非小细胞肺癌脑转移的患者在临床十分常见,患者的预后情况都较差。然而烷化剂替莫唑胺和PARP抑制剂Veliparib在这一疾病中的应用至今都没有文献报道。为了提高该类患者的预后效果,我们利用定量PCR的方法筛选了MGMT高表达的非小细胞肺癌脑转移患者57例。我们针对这一分子表型的患者随机分成3组,分别用安慰剂、替莫唑胺和联合替莫唑胺与Veliparib进行治疗,并观察后期生存情况。用安慰剂一组的患者的中位生存期只有75 d,而单独使用替莫唑胺治疗的一组患者中位生存期为82 d。与安慰剂组相比,联合替莫唑胺和Veliparib用药组患者中位生存期显著增加了46 d(p=0.028),其中位生存期为121 d。总的来说,我们用MGMT基因对非小细胞脑癌患者做了进一步的细分,并开创性地使用替莫唑胺和Veliparib联合应用对其治疗,疗效显著,为非小细胞肺癌脑转移的治疗提供切实可行临床依据。
Patients with non-small cell lung cancer brain metastases are very common in clinical, the prognosis of patients are poor. However, the alkylating agents temozolomide and PARP inhibitor Veliparib in the application of this disease has not been reported in the literature. In order to improve the prognosis of this kind of patients, we used quantitative PCR method to screen 57 MGMT patients with high expression of NSCLC. We aimed at this molecular phenotype patients were randomly divided into 3 groups, respectively, with placebo, temozolomide and temozolomide and Veliparib treatment, and to observe the late survival. The median survival for patients in the placebo group was 75 days compared to 82 days for the group treated with temozolomide alone. Median survival was significantly increased 46 days (p = 0.028) in patients treated with temozolomide and Veliparib compared with placebo, with a median survival of 121 days. Overall, we further subdivided non-small cell brain cancer patients with the MGMT gene and pioneered the use of temozolomide in combination with Veliparib for its efficacy and efficacy for treatment of non-small cell lung cancer brain metastases Practical clinical basis.