Clinical Study Of Temozolomide Synchronized By Whole Brain Radiation Therapy To Brain Metastasis

Objective: In this study,to analyze the effect and toxicity reaction of temozolomide synchronized by whole brain radiation therapy(WBRT)to Brain Metastasis in pateints,and observed efficacy and safety of the groups to provided better treatment basis to this kind of patients.Methods:A total of 46 patients with Brain Metastasis collected from Jan 2012 to December 2016 in Yan’an University Affiliated Hospital with primary lesions that have been pathology confirmed,and Brain Metastasis who visited our oncology department of our hospital and confirmed by CT or MRI and met the inclusion criterion were included into this study.All patients divided into Synchronization WBRT Group and Simplicity WBRT Group according to random number table.Cases in Simplicity WBRT Group only received WBRT,or added 10~20Gy,and cases in Synchronization WBRT Group received therapy of temozolomide synchronized by whole brain radiation therapy.The project of WBRT were as followed: The whole brain radiation therapy used 6MV X ray,DT 40 Gy,2.0Gy/f,until the end of four weeks after radio therapy,when it is necessary to give local added to 50~60Gy.The Project of temozolomide synchronized by whole brain radiation therapy were as followed: 40 Gy,2.0Gy/f for 4 weeks;oral temozolomide 75 mg /(m2·d)for 4 weeks,until the end of the radiation.In the 1 month after WBRT,the head MRI were taken and short-term efficacy was evaluated by Response Evaluation Criteria In Solid Tumors recommended by World health organization in both groups.Adverse events were recorded during treatment,and evaluated by Common Terminology Criteria For Adverse Events recommended by American National Cancer Institute.Results are analyzed by SPSS 22.0 statistical software,observed the recent efficiency and adverse reactions of the groups whatever they have some statistical significance.To evaluate the effect and safity of temozolomide synchronized by whole brain radiation therapy,if it can provide the best treatment plan,and improve the patients quality of life.Results:By comparing,The Age,gender,KPS scors pathological types of primary tumor,parts or size of primary tumor,location of primary tumor,metastasis in other organs and in both groups were not significantly different(P>0.05).;and the discovery condition of brain metastasis,number of brain metastasis and location of brain metastasis in both groups were not significantly different(P>0.05).The results obtained:(1)The response rate in Synchronization WBRT Group had the increasing trend compared with those in Simplicity WBRT Group,but the diference in both groups has no statistic meaning(P>0.05),but the disease control rate in Synchronization WBRT Group were singnificantly increased compared with that in only WBRT Group(P<0.05).(2)The organ classification of adverse events after treatment in brain metastasis included hemogram disorder,gastrointestinal dysfunction,skin and hepatobiliory disorders and urinary system disorders and common adverse events were platelet count,hair loss,nausea and vomitting,dizziness and decreased white cell count.The occurrence and severity of each adverse events were not significantly different in both groups(P>0.05).Conclusion:(1)Therapy of temozolomide synchronized by whole brain radiation therapy can significantly improve the short-term efficacy of patients with brain metatesis compared with only WBRT;(2)Therapy of temozolomide synchronized by whole brain radiation therapy has similar safety compared with only WBRT,the concomitant therapy is well tolerated.