Non-small Cell Lung Cancer With Brain Metastasis Brain Concurrent Chemoradiotherapy Term Efficacy Studies

[Background and Purpose]:In recent years,the incidence of brain metastasis from lung cancer rise sharply along with the incidence of the lung cancer rise year by year. About 20%～50%failed because of brain metastasis.The main treatment strategy of cancer patients with brain metastasis is whole brain radiotherapy,while there is few research about chemotherapy combined with radiotherapy for these patients.The aim of this study is to evaluate the therapeutic effect,survival rate and toxicity of chemotherapy with TXT regimen given concurrently with whole brain radiotherapy in these patients.[Methods]:From Sep.2007 to sep.2008,forty eight patients with brain metastasis from lung cancer were divided randomly into two groups:23 patients(16 male,7 female) received concurrent chemoradiotherapy(chemoradiotherapy group),the other 25 patients(14 male,11 female) received only radiotherapy(radiotherapy group).In the chemoradiotherapy group,11patients were adenocarcinoma,10patients were squamous cell carcinoma.2 patients were others.In the radiotherapy group,14 patients were adenocarcinoma,10 patients were squamous cell carcinoma.1 patient was others.For both groups,the same radiation technique was given with conventional fraction.Radiotherapy was delivered by 6MV.Fractionations was delivered 10Gy/5 factions/week.The total dose was 30Gy/10F/2W or 40Gy/20F/4W.For chemo radiotherapy group,the patients were also given concurrent chemotherapy(docetaxel 60mgd1,8).[Results]:The response rate and complete response in the chemoradiotherapy group was significantly higher than that in the radiotherapy group.(73.9%vs 40%,P＜0.05 and21.7%vs 8%,P＜0.05).Among 23 patients assessable for response in the chemo radiotherapy group,17(73.9%) of 23 responded,including 5(21.7%) patients with a complete response and 8(52.2%) patients with a partial response.With radiotherapy alone,10(40%) of 25 assessable patients responded,including2(8%) complete responses and 8(32%) partial responses.The acute toxic effect of gradeⅢ/Ⅳmyelotoxicity,nausea/vomiting in the chemo radiotherapy group(leucocytes 34.8%, blood platelet8.7%,nausea/vomiting 26.1%)were significantly higher than those in the radiotherapy group(leucocytes 8%,blood platelet 4%nausea/vomiting 2%)(P＜0.05). 4 Conclusions:Concurrent chemoradiotherapy can be safely performed for patients with brain metastasis of lung cancer and its short term response is quite satisfactory.It can also increase the acute toxic effect,but all patients can tolerate.It may be worthy of further clinical investigation.