选择性动脉灌注化疗联合靶向药物治疗非小细胞肺癌多发脑转移

BACKGROUND AND OBJECTIVE: The aim of this study is to evaluate the efficacy of selected arterial infusion chemotherapy in treating non-small cell lung cancer (NSCLC) with multiple brain metastases and corresponding factors to influencing prognosis. METHODS: From September 2008 to October 2011, a total of 31 patients of NSCLC with multiple brain metastases (≥3) received selected incranial, bronchial and corresponding target arterial infusion chemotherapy combined with EGFR-TKIs. Interventional treatment was performed every four weeks, two-six cycles with synchronized or sequential targeted drugs (erlotinib, gefitinib or icotinib). Follow-up CT and MRI were regularly finished at interval of four weeks after two cycles of interventional treatment were finished or during taking targeted drugs in order to evaluate efficacy of the therapy. The procedure was stopped for the tumor disease was worse or the patient could not tolerate the toxity of drugs any longer. RESULTS: 31 patients was performed two to six cycles of interventional therapy, 3cycles at average. Response assessment showed that 5 (16.1%) patients got a complete response (CR), 7 (22.6%) had a partial response (PR), 11 (35.5%) had a stable disease (SD) and 8 (25.8%) had a progressive disease (PD). The objective response rate (ORR) was 38.7%, and the disease control rate was 74.2%. The median progression free survival (PFS) and overall survival (OS) were 13.1 months and 15.1 months. The 6-month survival rate, one-year survival rate and two-year survival rate were 79%, 61.1%, and 31.1%, respectively. The patients' OS and PFS were influenced by smoking state, tumor pathology, extracranial metastases, period of targeted drug taking and performance status, not by sex, age, before therapy and the total of brain metastases. CONCLUSION: Selected arterial infusion chemotherapy with targeted drugs is one of the most effective and safe treatment to NSCLC with multiple brain metastases. Smoking status, tumor pathology, extracranial metastases, targeted drug taking and performance status are corresponding the patient's prognosis.