EGFR-TKI序贯化疗对EGFR-TKI获得性耐药的中晚期非小细胞肺癌的疗效观察  

The efficacy of EGFR-TKI sequential chemotherapy on advanced non-small cell lung cancer after acquired resistance to EGFR-TKI

作　　者：陈咏梅[1] 蒋志红[1] 陈金云[1] 张燕[1] 

机构地区：[1]海军总医院呼吸内科,北京100048

出　　处：《临床军医杂志》2015年第11期1101-1104,共4页Clinical Journal of Medical Officers

摘　　要：目的探讨序贯化疗对表皮生长因子受体-酪氨酸激酶抑制剂（EGFR-TKI）获得性耐药的中晚期非小细胞肺癌（NSCLC）患者的疗效及安全性。方法选择2012年8月至2013年8月我院收治的104例EGFR-TKI获得性耐药的中晚期NSCLC患者作为研究对象,采用随机数字表法将患者分为EGFR-TKI序贯化疗组及单纯化疗组,每组52例患者。对比分析1年内两组患者的疗效、不良反应发生情况及生存率。结果 EGFR-TKI序贯化疗组患者的近期总有效率为73.08%,显著高于单纯化疗组的48.08%（χ~2=6.805,P〈0.01）。EGFR-TKI序贯化疗组患者的无进展生存时间为（6.92±1.78）个月,而单纯化疗组患者的无进展生存时间为（4.78±1.12）个月,两组比较,差异有显著统计学意义（t=7.338,P〈0.01）。EGFR-TKI序贯化疗组患者的总生存率、无瘤生存率高于单纯化疗组,而复发率低于单纯化疗组（P〈0.05）。两组患者不良反应发生率比较,差异无统计学意义（P〉0.05）。结论中晚期NSCLC患者EGFR-TKI治疗失败后,应用EGFR-TKI序贯化疗可有效提高患者治疗效果,延缓病情进展,提高患者远期生存率,且不良反应可耐受,是中晚期NSCLC患者EGFR-TKI获得性耐药后的有效治疗策略。Objective To explore the safety and efficacy of EGFR-TKI sequential chemotherapy on advanced non-small cell lung cancer（ NSCLC） after acquired resistance to EGFR-TKI. Methods Totally 104 cases of acquired resistance to EGFR-TKI advanced NSCLC patients in our hospital were divided into EGFR-TKI sequential chemotherapy group and chemotherapy group from August 2012 to August 2013 in our hospital,with 52 cases in each group. The efficiency,incidence condition of adverse reaction and survival in 1 year of the two groups were compared. Results The chemotherapy recent total effective rate of sequential chemotherapy group was 73. 08%. It was higher than that in chemotherapy group which was 48. 08%（χ2 =6. 805,P〈0. 01）. The sequential progression-free survival of sequential chemotherapy group were （6. 92 ± 1. 78） months,which were higher than chemotherapy group which were （4. 78 ± 1. 12） months（t=7. 338,P〈0. 01）. The OS,DFS of EGFR-TKI sequential chemotherapy group were higher than chemotherapy alone group,and the recurrence rate was lower than the chemotherapy group （ P〈0. 05 ） . Two chemotherapy adverse reaction rates were no significant difference （ P〉0. 05 ） . Conclusion Patients of advanced NSCLC with EGFR-TKI treatment failure after application of EGFR-TKI sequential chemotherapy can improve patient outcomes, slow disease progression and improve long-term survival of pa-tients,and the adverse reaction is acceptable. It is advanced NSCLC EGFR-TKI get effective drug resistance after treatment strategies.

关 键 词：肺肿瘤 中晚期非小细胞肺癌 表皮生长因子受体-酪氨酸激酶抑制剂 序贯化疗 获得性耐药 

分 类 号：R734.2[医药卫生—肿瘤]