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预防性脑照射不能改善NSCLC患者生存率

2012-09-12 不详 网络

局部晚期非小细胞肺癌预防性脑照射
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威斯康辛大学医学院放射肿瘤学教授Elizabeth Gore博士在芝加哥胸部肿瘤多学科研讨会上报告称，一项针对治疗后无疾病进展的340例局部晚期非小细胞肺癌(NSCLC)患者的随机对照试验表明，预防性脑照射(PCI)可减少5年脑转移率，但未能改善总生存率。 该试验证实了PCI减少脑转移率的有效性，但该试验因患者入组缓慢而提前结束，未能招募到足够的患者以回答有关PCI是否改善Ⅲ期NSCLC患者

威斯康辛大学医学院放射肿瘤学教授Elizabeth Gore博士在芝加哥胸部肿瘤多学科研讨会上报告称，一项针对治疗后无疾病进展的340例局部晚期非小细胞肺癌(NSCLC)患者的随机对照试验表明，预防性脑照射(PCI)可减少5年脑转移率，但未能改善总生存率。

该试验证实了PCI减少脑转移率的有效性，但该试验因患者入组缓慢而提前结束，未能招募到足够的患者以回答有关PCI是否改善Ⅲ期NSCLC患者总生存率的主要问题。Gore博士说：“我需要强调的是参与临床试验的必要性，尤其对于肺癌患者。尽管肺癌是美国癌症死亡的首要原因，但研究并不充分。”



Elizabeth Gore博士

在该项研究中，所有患者的中位随访时间为24.2个月，生存患者为58.6个月。结果显示，随机接受15次30 Gy PCI患者的5年脑转移率为17.3%，而观察组患者为26.8%，两者差异显著(P=0.009)。但5年生存率(26.1% vs. 24.6%)或无病生存率(18.5% vs. 14.9%)均未见显著组间差异。在治疗失败的患者中，10%的PCI组患者和23%的观察组患者首次出现脑转移(BM)。PCI组和观察组BM是首次转移的唯一部位的患者比例分别为9.1%和21.5%。多变量分析显示，PCI与BM减少显著相关，而非鳞癌组织学特征与BM风险增加相关。在该项试验中，根据组织学特征进行总脑转移率分组分析的可信度不够。

研究者指出，脑转移对肺癌患者生活质量影响较大，在PCI成为标准治疗之前，需要进一步确定哪些患者在生存率方面受益更大。

该研讨会由美国临床肿瘤学会(ASCO)、美国放射肿瘤学会(ASRO)、国际肺癌研究协会(IASLC)和芝加哥大学联合主办。Gore博士及其同事无利益冲突披露。


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    2012-12-10 医者仁心

    #患者生存#

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    2013-05-17 839640778

    #预防性#

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    2012-12-10 jklm09

    #SCLC患者#

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    2012-09-14 医者仁心

    #生存率#

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    2012-09-14 xiongliangxl

    #NSCLC患者#

    0