目的:探讨替莫唑胺(TMZ)在O6甲基鸟嘌呤DNA甲基转移酶(MGM T)高表达的非小细胞肺癌脑转移中的临床效果和不良反应.方法:收集非小细胞肺癌脑转移患者90例,根据治疗方式分为全脑化疗联合替莫唑胺组和单纯化疗组,对所有患者进行为期2年的随访,记录两组的有效率、生存周期以及不良反应.结果:放疗结束后1个月后对两组患者的治疗效果进行评价,联合组患者有效率为61.6%,单纯放疗组患者有效率为37.3%,差异有统计学意义(P<0.022);联合组中位生存时间为18个月,放疗组中位生存时间为16个月,两组比较差异无统计学意义(P>0.05);联合组在中性粒细胞减少以及肝功能损伤方面发生率高于单纯放疗组,差异有统计学意义(P<0.05).结论:应用替莫唑胺联合放疗可以有效增加M GM T高表达的非小细胞肺癌脑转移患者的有效率而不增加患者的不良反应,患者可耐受.%Objective:To evaluate the efficacy and safety of temozolomide in patients with the high expression of O6 methylguanine DNA methyltransferase of non-small-cell lung cancer patients with brain metastasis .Methods :90 patients were with non-small cell lung cancer with brain metastasis ,according to the treatment was divided into whole brain combination chemotherapy with temozolomide group and only chemotherapy group .All patients were follow-up for 2 years ,efficacy rates and adverse reaction were recorded .Results :After radiotherapy for 1 month ,all patients were evaluated the therapeutic effect ,effective rate in the combined group was 61 .6% and 37 .3% in simple radiotherapy group ,the difference was statistically significant (P<0 .05) .Median survival period was 18 months and 16 months respectively .However ,there was no statistically significant between the two groups (P>0 .05) . The occurrence of neutropenia and liver function injury was higher than that in combined group ,the difference was statistically significant (P<0 .05) .Conclusion :Application of combined radiotherapy with temozolomide can effec-tively increase the survival rates in the high expression of MGMT of patients with brain metastases from non-small cell lung cancer without increasing the adverse reaction .It is worth further research and generalize in clinical admin-istration .
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