Abstract
We explored and compared the clinical effects of whole-brain radiotherapy (wbrt) with and without elemene liposomes in patients with multiple brain metastases from non-small-cell lung carcinoma (nsclc). We retrospectively analyzed 62 patients with multiple brain metastases from nsclc who received wbrt (30 Gy in 10 fractions) at Shengjing Hospital of China Medical University from January 2012 to May 2013. In 30 patients, elemene liposomes (400 mg) were injected intravenously via a peripherally inserted central catheter for 21 consecutive days from the first day of radiotherapy. Overall survival (os) and nervous system progression-free survival (npfs) for the two groups were compared by Kaplan-Meier analysis. Factors influencing npfs were examined by Cox regression analysis. Chi-square or Fisher exact tests were used for group comparisons. The median os was 9.0 months in the wbrt plus elemene group and 7.8 months in the wbrt-alone group (p = 0.581); the equivalent median npfs durations were 5.2 months and 3.7 months (p = 0.005). Patient treatment plan was an independent factor associated with npfs (p = 0.002). Tumour response and disease-control rates in the wbrt plus elemene group were 26.67% and 76.67% respectively; they were 18.75% and 62.5% in the wbrt group (p = 0.452). Compared with the patients in the wbrt-alone group, significantly fewer patients in the wbrt plus elemene group developed headaches (p = 0.04); quality of life was also significantly higher in the wbrt plus elemene group both at 1 month and at 2 months (p = 0.021 and p = 0.001 respectively). The addition of elemene liposomes to wbrt might prolong npfs in patients with multiple brain metastases from nsclc, while also reducing the incidence of headache and improving patient quality of life.
Highlights
About 20% –40% of patients with non-small cell lung cancer develop brain metastasis, with a poor prognosis[1]
Whole-brain radiotherapy, either alone or combined with surgery, and stereotactic radiosurgery have been the standard treatments for brain metastasis, overall survival after wbrt is only 4–5 months
The presence of the blood–brain barrier makes it difficult for chemotherapeutic drugs to reach intracranial lesions[2], and radiosensitizing agents represent a means of improving survival and quality of life for patients with brain metastases, while reducing the side effects of chemotherapy
Summary
About 20% –40% of patients with non-small cell lung cancer (nsclc) develop brain metastasis, with a poor prognosis[1]. The presence of the blood–brain barrier makes it difficult for chemotherapeutic drugs to reach intracranial lesions[2], and radiosensitizing agents represent a means of improving survival and quality of life for patients with brain metastases, while reducing the side effects of chemotherapy. Elemene (1-met hy l-1-v i ny l-2,4-d i i sopropeny l-cyclohexane) is a natural compound found in a variety of plants. It occurs as β, γ, and δ isomers, with β-elemene accounting for 85% of the total[3]. Elemene has demonstrated inhibitory effects on leukemia and on breast, prostate, lung, and metastatic brain e377
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