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动脉灌注介入治疗联合厄洛替尼治疗晚期非小细胞肺癌合并脑转移疗效分析

孙立伟1,任秀宝2   

  1. 1. 天津市环湖医院
    2. 天津市肿瘤医院生物治疗科
  • 收稿日期:2013-12-30 修回日期:2014-01-03 出版日期:2014-03-15 发布日期:2014-03-15
  • 通讯作者: 任秀宝

Efficacy analysis on Arterial interventional therapy combined with erlotinib in advanced non-small-cell lung cancer with brain metastasis

Li-Wei SUN1,   

  • Received:2013-12-30 Revised:2014-01-03 Published:2014-03-15 Online:2014-03-15

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摘要： 目的 回顾性分析动脉灌注介入治疗联合表皮生长因子受体（EGFR）酪氨酸激酶抑制剂（TKI）厄洛替尼治疗非小细胞肺癌合并脑转移患者之疗效，分析影响其预后相关因素。方法 共45例经CT或MRI确诊的非小细胞肺癌合并脑转移患者行选择性支气管动脉和颅内动脉化疗药物灌注治疗2～6个周期，治疗间歇期同步或后续予以厄洛替尼治疗，每两个治疗周期或临床考虑疾病进展时评价疗效。结果 均完成至少2个周期治疗，中位治疗周期为3个周期，完全缓解7例（15.56%）、部分缓解12例（26.67%）、稳定16例（35.56%）、进展10例（22.22%），客观缓解率42.22%、疾病控制率77.78%。45例患者无进展生存期为7～29个月、中位时间11.00个月，总生存时间9～44个月、中位时间17.00个月。影响因素分析显示，体力状态评分低较评分高者无进展生存期和总生存时间更长。 结论 动脉灌注介入治疗联合厄洛替尼治疗非小细胞肺癌脑转移，获得了较好的近期疗效，并显示出患者的生存时间获益，而且副反应轻微，适应症广泛，减少了由于长期放化疗所造成的不良并发症。

关键词: 非小细胞肺癌, 脑转移, 动脉灌注介入治疗, 厄洛替尼, 近期疗效, 生存分析

Abstract: Objective Brain metastasis was the main reason for the death of non-small cell lung cancer (non-small cell lung cancer, NSCLC). This study retrospectively analyzed the clinical efficacy and prognostic factors of arterial interventional therapy combined with epidermal growth factor receptor (epidermal growth factor receptor, EGFR)and tyrosine kinase inhibitors (tyrosine kinase inhibitors, TKI) erlotinib (erlotinib) Method Form January 2009 to January 2012,45 NSCLC patients with brain metastasis confirmed by pathology or cytology were collected in our study. They all underwent infusion chemotherapy two-six cycles by selective bronchial artery or intracranial arterial. Erlotinib was used simultaneously or sequentially with the infusion chemotherapy.We assessed the clinical efficacy every two cycles or when the disease got progressed. Results All the patients received at least two cycles of treatment.The median number of cycles was 3(range 1-6). The results were as follows: complete remission (CR) 7 cases (15.56%), partial remission (PR) 12 cases (26.67%), stable (SD) 16 cases (35.56%), progression (PD) 10 cases (22.22%).The objective response rate (ORR, CR + PR) and disease control rate (DCR, CR + PR + SD) was 42.22% and 77.78% respectively. 45 cases of patients with progression-free survival (PFS) time of 7-29 months, the median PFS time was 11.00 months，the overall survival time was 9-44 months, the median OS was 17.00 months. Univariate analysis showed that patients with low PS score has longer PFS than those with higher PS score，patients with low PS score has longer OS than those with higher PS score. Conclusion Arterial interventional therapy combined with erlotinib has got a better short-term effect and prolonged the survival time but with mild side effects. It would be a useful treatment for NSCLC patients with brain metastasis.

Key words: Non-small cell lung cancer, Brain metastasis, Arterial intervention, Erlotinib, Term efficacy, Survival analysis