Effect And Safety Analysis Of EGFR-TKIs Combined With Radiotherapy In The Treatment Of Brain Metastases Of Non Small Cell Lung Cancer

Objective: The purpose of this study is to explore the short-term curative effect,and side effect between epidermal growth factor receptor tyrosine kinase inhibitors(EGFR-TKIs)combined with the whole brain radiotherapy and chemotherapy combined with the whole brain radiotherapy in the treatment of non-small cell lung cancer patients with brain metastasis.Methods: The clinical data of 100 patients with brain metastases from non-small cell lung cancer were analyzed retrospectively.These patients were divided into EGFR-TKIs treatment group and control group with 50 patients in each group according to different treatment methods.The therapeutic effect of the patient in EGFR-TKIs treatment group was evaluated 1 month after treatment.Treatment effectively continues to be treated when there is an intolerable side reaction or when the disease progresses.A total of 50 patients in the control group were treated with platinum-based chemotherapy combined with brain radiotherapy.The patient was treated with chemotherapy for 21 days,and the treatment effect was evaluated after 2 cycles.The effective patients continued to be treated for 2~4 cycles.All subjects were evaluated by CT or MRI.The curative effect was evaluated by solid tumor treatment evaluation standard(Response Evaluation Criteria in Solid Tumors,RECIST 1.1 Edition),and the adverse reaction was according to the standard of toxic reaction of WHO anticancer drug.The patients were followed up,followed by outpatient visits,regular visits to the hospital or telephone survey.The therapeutic effect evaluation of the two groups was analyzed by chi-square test,α= 0.05 as the testing standard,To consider P<0.05 as statistically significant.Results: 1,Two groups of patients were evaluated after 4 cycles of chemotherapy or after 3 months of targeted therapy.The ORR(Brain parenchymal lesions)in the EGFR-TKIs treatment group was higher than that of the control group.The difference was statistically significant(P<0.05).There was no significant difference in DCR(Brain parenchymal lesions)between the two groups.(P>0.05).The ORR(The body lesions)in the combined treatment group was higher that in the control group.The difference was statistically significant(P< 0.05).There was no significant difference in DCR(The body lesions)between the two groups.(P>0.05).2,In the analysis of patients with EGRF gene mutation subgroup,the OR R and DCR of patients with EGRF-TKIs in the treatment group were significantly higher than those in the control group,and the difference was statistically significant.(P<0.05).3,2 groups of patients during treatment were not tolerated.Acne rash was the most common adverse reaction in the EGRF-TKIs treatment group.The incidence rate was higher than that in the control group(P<0.05).Compared with the EGRF-TKIs treatment group,the incidence of gastrointestinal reaction and bone marrow suppression in the control group was higher than that in the EGRF-TKIs treatment group(P<0.05).Conclusion: 1,Non-small cell lung cancer patients with brain metastasis in the EGFR-TKIs treatment group can obtain better objective response rate(ORR),high safety,and the toxicity is well tolerated.2,For patients with EGFR mutant non-small cell lung cancer,If combined with radiotherapy,EGRF-TKIs should be applied prior to chemotherapy in the treatment of patients.