Zhang Guoqiao, Zeng Rong, Wang Kai, A Yinzhuoyang, Li Linhai, Gong Kunmei
Department of Oncology, The First People's Hospital of Yunnan Province, Kunming, Yunnan 650032, P.R. China.
Department of General Surgery, The First People's Hospital of Yunnan Province, Kunming, Yunnan 650032, P.R. China.
Oncol Lett. 2019 Mar;17(3):2874-2880. doi: 10.3892/ol.2019.9894. Epub 2019 Jan 4.
Clinical efficacy and adverse reactions of pemetrexed combined with stereotactic gamma-ray radiotherapy in the treatment of patients with lung adenocarcinoma brain metastasis in The First People's Hospital of Yunnan Province were evaluated. A total of 67 patients with lung adenocarcinoma brain metastasis in experimental group were treated with simple pemetrexed chemotherapy, and then with radiotherapy, followed by pemetrexed chemotherapy. Their treatment results were compared with those of 53 patients treated with simple gamma knife in control group. The results were analyzed by comparing the clinical efficacy, side reactions, serum level changes, and survival between the two groups. Among 67 patients in the experimental group, there were 16 cases of complete response (CR), 39 cases of partial response (PR), 7 cases of stable disease (SD) and 5 cases of progressive disease (PD), with an effective rate of 82.09% (55/67) and a tumor local control rate of 92.54% (62/67). Among 53 patients in the control group, there were 13 cases of CR, 20 cases of PR, 9 cases of SD and 11 cases of PD, with an effective rate of 62.26% (33/53) and a tumor local control rate of 79.25% (42/53). There were statistically significant differences in the effective rate and local control rate between the two groups (P<0.05). The 6-, 12- and 24-month survival rates in experimental group were higher than those in control group (P<0.05). The main adverse reactions after pemetrexed combined with radiotherapy were lower than those after simple radiotherapy (P<0.05). The expression levels of the tumor markers carcinoembryonic antigen (CEA) and cytokeratin fragment antigen 21-1 (CYFRA21-1) in the two groups of patients after treatment were lower than those before treatment (P<0.05). After treatment, the expression levels of serum CEA and CYFRA21-1 in the experimental group were significantly lower than those in the control group (P<0.05). Pemetrexed combined with radiotherapy in the treatment of lung adenocarcinoma brain metastasis is more effective than simple radiotherapy, with lighter adverse reactions, worthy of clinical application and promotion.
评估云南省第一人民医院培美曲塞联合立体定向伽马射线放射治疗肺腺癌脑转移患者的临床疗效及不良反应。实验组67例肺腺癌脑转移患者先接受单纯培美曲塞化疗，再行放射治疗，之后继续培美曲塞化疗。将其治疗结果与对照组53例单纯接受伽马刀治疗的患者进行比较。通过比较两组的临床疗效、不良反应、血清水平变化及生存率来分析结果。实验组67例患者中，完全缓解（CR）16例，部分缓解（PR）39例，病情稳定（SD）7例，疾病进展（PD）5例，有效率为82.09%（55/67），肿瘤局部控制率为92.54%（62/67）。对照组53例患者中，CR 13例，PR 20例，SD 9例，PD 11例，有效率为62.26%（33/53），肿瘤局部控制率为79.25%（42/53）。两组的有效率和局部控制率差异有统计学意义（P<0.05）。实验组6个月、12个月及24个月生存率高于对照组（P<0.05）。培美曲塞联合放射治疗后的主要不良反应低于单纯放射治疗（P<0.05）。两组患者治疗后肿瘤标志物癌胚抗原（CEA）和细胞角蛋白片段抗原21-1（CYFRA21-1）的表达水平均低于治疗前（P<0.05）。治疗后，实验组血清CEA和CYFRA21-1的表达水平明显低于对照组（P<0.
