目的 研究厄洛替尼联合全脑局部推量放疗（WBRT⁃SIB）治疗EGFR 突变的肺腺癌伴多发脑转移患者的临床有效性和安全性。方法 45例EGFR突变肺腺癌伴多发性脑转移患者，根据是否使用厄洛替尼分为联合治疗组22例，放疗组23例，2组患者均予以WBRT⁃SIB 治疗脑转移瘤，比较2组患者近期及远期疗效、不良反应情况。结果 放化疗组患者近期有效缓解率为77.72%，显著高于放疗组的47.82%，差异具有统计学意义（P < 0.05）。联合治疗组1年生存率59.09%（13/22）显著高于放疗组43.47%（10/23），差异具有统计学意义（P < 0.05）。两组患者主要不良反应为乏力、皮疹，多数轻微，对症治疗后好转，无Ⅳ度不良反应。结论 伴EGFR突变阳性肺腺癌伴多发脑转移患者采取WBRT⁃SIB联合厄洛替尼靶向治疗具有较好的临床效果，在延长患者生存时间的同时也降低了患者不良反应发生率，值得推广。

Objective To detect the clinical efficacy and safety of erlotinib combined with simultaneouswhole brain radiotherapy with simultaneous integrated boost（WBRT⁃SIB）in patients with lung adenocarcinomawith multiple cerebral metastases with EGFR mutation. Methods 45 pulmonary adenocarcinoma patients withbrain metastases，treated with erlotinib combined with WBRT⁃SIB were in combination therapy group（n = 22）andpatients treated with WBRT⁃SIB only were in radiotherapy group（n = 23）. The short⁃term effects，long⁃term effectsand adverse reactions of these two groups were compared. Results The short⁃term effective response rate（RR）ofthe combination therapy group was 77.72% ，which was significantly higher than that of the radiotherapy group（47.82%）（P < 0.05）. The one⁃year survival rate of the combination therapy group was 59.09%（13/22），whichwas significantly higher than that of the radiotherapy group 43.47%（10/23）（P < 0.05）. The main adverse reactionsin the two groups were fatigue and rash，most of which were mild，improved after symptomatic treatment，and noⅣadverse reactions. Conclusion Pulmonary adenocarcinoma patients with multiple brain metastases，have anideal clinical effect with WBRT⁃SIB combined with erlotinib. It prolongs the survival time of patients and reducesthe incidence of adverse reactions. It is worthy of promotion.