肺癌脑转移的优化治疗

目的：观察超级伽玛刀与含有鬼臼噻吩甙（VM-26）的联合化疗方案相结合，综合治疗肺癌脑转移的临床疗效。方法：收集我院2004年9月-2008年2月超级伽玛刀治疗肺癌脑转移中继续接受化学治疗的患者29例。在超级伽玛刀治疗后2～3周，开始行含VM-26的联合化疗，2周期化疗后行头部MRI和胸部CT评价疗效。一般接受2～6周期化疗。结果：全组病例神经症状临床缓解率为100．0％，颅内肿瘤局部控制率为86．5％，肺内原发肿瘤局部控制率43．7％，1年生存率52．0％，2年生存率24．4％，中位生存期13．7个月，中位无进展生存期5个月，无严重并发症出现。结论：超级伽玛刀联合含VM-26化疗的治疗可能是肺癌脑转移最优化的综合治疗方案之一，疗效确切，明显延长患者生存时间，提高其生存质量。

Optimal treatment of lung cancer with brain metastasis

Objective： To study the therapeutic effects of combined chemotherapy and γ-knife to lung cancer with brain metastasis. Methods：From September 2004 to February 2008, 29 lung cancer patients with brain metastasis were received combined chemotherapy after cured by γ-knife. Two to three weeks later after γ-knife therapy, they were received combined chemotherapy with VM26 for two cycles. Response was evaluated by brain MRI and chest CT after γ-knife therapy and at least 2 cycles of chemotherapy were completed. All patients received 4-6 cycles combined chemotherapy. Results： All the patients completed γ-knife combined with chemotherapy. The alleviate rate of neurolonical symptoms was 100, 0%. Total response rate of metastasis tumor in brain was 86.5% , and the response rate of primary pulmonary tumor was 44. 4%. The 1-year and 2-year survival rates were 52. 0% and 24. 4%. The median survival time was 13.7 months. Progress free survival was 5 months. Conclusion：Chemotherapy combined with γ-knife maybe the optimal treatment for lung cancer with brain metastasis, which can prolong survival and improve quality of life.