| Objective:Explore the short-term efficacy of pemetrexed combined with platinum drugs in the treatment of asymptomatic brain metastasis of advanced lung adenocarcinoma,so as to provide basis for clinical treatment of asymptomatic brain metastasis of advanced lung adenocarcinoma.Method: Forty-one patients with asymptomatic brain metastases from advanced lung adenocarcinoma were collected.The patients were from the Affiliated Hospital of Qinghai University,Qinghai Provincial People’s Hospital and Qinghai Red Cross Hospital from January 1,2012 to December 31,2018.Imaging data of brain lesions and systemic lesions before and after pemetrexed combined with platinum drugs for at least 4 cycles were recorded respectively,Brain metastases were excluded from all systemic lesions in this study.SPSS22.0 software was used to analyze the data.ORR,DCR and TTP were used as observation indicators to evaluate the short-term efficacy,and whether age,gender and other factors affected the observation indicators were analyzed.Results: 1,General characteristics: 20 males and 21 females,with a male-female ratio of 0.95: 1;The age range is 30-75 years old,the median age is 66 years old,27 patients over 60 years old account for 65.8%;22 patients(53.7%)did not smoke.2,Clinical features: 29 patients with more than 3 brain metastases,23 patients treated with carboplatin and 12 patients with ECOG score of 2,accounting for 70.7%,56.1% and 29.3% respectively.3,Among 41 patients with brain lesions,14 cases achieved PR,19 cases achieved SD,and 8 cases achieved PD.ORR and DCR of brain lesions were 34.2% and 80.5%,respectively.Among the 41 patients with systemic lesions,10 cases achieved PR,19 cases achieved SD,and 12 cases achieved PD.The ORR of systemic lesions was 24.4%,and the DCR was 70.7%.After chi-square test analysis,there was no significant difference in ORR between brain metastases and systemic lesions(p = 0.332),and there was no difference in DCR(p = 0.304).4,The median TTP of brain lesions is 6.0 months(95% confidence interval 4.988-7.012)and that of whole body lesions is 5.2 months(95% confidence interval 4.499-5.901).After Log-rank test,p = 0.033 is obtained,and the difference is statistically significant.5,Through statistical analysis,the patient’s sex,age,smoking history,number of brain metastases,ECOG score and platinum drug selection have no effect on ORR,DCR and TTP.6,No obvious side effects were observed in the treatment process.Conclusion: After pemetrexed combined with platinum drugs for asymptomatic brain metastases from advanced lung adenocarcinoma,the short-term efficacy of brain metastases is as good as that of systemic lesions. |
