摘要
目的探讨表皮生长因子受体(EGFR)基因状态对肺腺癌脑转移放疗的影响,为临床脑转移治疗模式和个体化治疗提供参考。方法回顾性分析郑州大学第一附属医院收治的肺腺癌脑转移患者57例,均接受全脑放疗(30Gy/10F或40Gy/20F)及病灶局部推量治疗(20Gy/10F)。比较EGFR突变型(mtEGFR)和野生型(wtEGFR)患者的有效率(RR)、颅内无疾病进展生存期(iPFS)。采用Chi-squareTest和Fisher确切概率法分析RR,采用Logrank法、Cox-Regression模型进行单因素和多因素分析。结果57例患者,突变型与野生型RR为79.41%和47.83%(P=0.013),中位iPFS是12.0个月和6.0个月(P<0.01)。19外显子缺失突变和21外显子L858R突变亚组的RR和中位iPFS无差异(P>0.05)。结论mtEGFR肺腺癌脑转移对放疗敏感性更高,iPFS更长,mtEGFR亚组之间无显著差异。
Objective To investigate the effect of epidermal growth factor receptor( EGFR ) gene status on radiotherapy for brain metastasis in lung adenocarcinoma,and provide a reference for clinical brain metastasis treatment mode and individualized treatment. Methods Fifty-seven patients of lung adenocarcinoma with brain metastasis treated by the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. All patients accepted whole-brain radiotherapy(30 Gy/10 F or 40 Gy/ 20 F ) and local brain lesions boosted by 20 Gy/10 F. The response rate(RR),intracranial procession-free survival(iPFS) between patients harbored EGFR mutation ( mtEGFR )and wild-type( wtEGFR ) were compared. Chi-square Test and Fisher Test were used for analyze RR,Logrank and Cox-Regression model were used for single-factor and multi-factor analysis. Results For these 57 patients,RR in mtEGFR and wtEGFR patients were 79.41% and 47.83%( P = 0.013),media iPFS were 12.0 months and 6.0 months ( P < 0.01). RR and iPFS between EGFR 19 exon deletion mutation and 21 exon L858R mutation subgroups was no statistical difference( P > 0.05). Conclusion Lung adenocarcinoma with brain metastasis patients harbored mtEGFR are more sensitive to radiotherapy,iPFS is longer,and there are no difference between subgroups of mtEGFR .
作者
张凤鸣
李班班
史云舒
李盼华
李醒亚
ZHANG Feng-ming;LI Ban-ban;SHI Yun-shu;LI Pan-hua;LI Xing-ya(Department of oncology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《河南医学研究》
CAS
2019年第14期2505-2507,共3页
Henan Medical Research
关键词
肺腺癌
脑转移
放疗
表皮生长因子受体
lung adenocarcinoma
brain metastases
radiotherapy
epidermal growth factor receptor
