表皮生长因子受体酪氨酸激酶抑制剂联合同步放疗治疗晚期非鳞肺癌疗效观察  

Effect of EGFR - TKI combined with concurrent radiotherapy in the treatment of advanced non - squamous lung cancer

作　　者：朱川[1] 蔡祖艾[1] 李湘宜[1] 任必勇[1] 熊德明[1] 黄小平[1] 贾茜[1] 吴佼佼[1] 

机构地区：[1]重庆三峡中心医院肿瘤防治中心,重庆市443000

出　　处：《中国基层医药》2016年第11期1687-1691,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKI）靶向药物联合胸部同步放疗治疗ⅢB／Ⅳ期非鳞肺癌患者的安全性及临床疗效。方法回顾性分析64例符合条件非鳞肺癌住院病例，其基因检测均存在EGFR—TKI药物治疗敏感型突变。其中单纯口服EGFR—TKI靶向药物（单纯治疗组）26例；口服EGFR—TKI靶向药物治疗基础上，同时联合胸部放疗（联合治疗组）38例；所有患者治疗中及治疗后均观察记录治疗毒副反应并进行随访、复查。分析指标包括急性毒性反应、疾病缓解率与生存获益。结果近期疗效方面，联合治疗组疾病客观缓解率较高，差异有统计学意义（71．1％比46．2％，x2=4．02，P=0．02）。联合组及单独治疗组中位PFS分别为11．5、10．1月，中位0s分别为26．7、23．4月，差异均无统计学意义（P值分别为0．85及0．32）。两组常见毒副反应为皮疹、胃肠道反应，发生率相似。联合组胸部及血液学毒性反应明显增加，但主要限于1～2级，未发生治疗相关性死亡。结论口服EGFR-TKI靶向药物基础上联合胸部同步放疗治疗存在EGFR—TKI药物治疗敏感型突变的晚期非鳞肺癌，其毒副反应可接受，疾病客观反应率较好，生存方面优势有限，有待进一步分层研究。Objective To evaluate the safety and curative effect of epidermal growth factor receptor tyrosine kinase inhibitor （EGFR -TKI） combined with concurrent radiotherapy in the treatment of stage IIIB or IV non - squamous lung cancer patients. Methods 64 patients with EGFR mutant type advanced non - squamous lung cancer were enrolled in this study. 26 patients were treated with EGFR -TKI （single treatment group） ,38 patients were treated with EGFR - TKI combined with concurrent radiotherapy （ combined treatment group）. The acute toxicity reaction, the objective response rate and the survival benefit of all the patients were evaluated. Results In recent curative effect, the combined treatment group showed higher objective response rate, and the ORR between the two groups had statistically significant difference （ 71.1% vs 46.2%, X2 = 4.02, P = 0.02 ）. In the combined treatment group, the median progression free survival time was 11.5 months, and the median survival time was 26.7 months. In the single treatment group ,the median progression free survival time was 10.1 months, and the median survival time was 23.4 months. The differences between the two groups were not statisticaliy significant. The main adverse reactions were skin rash and gastrointestinal reaction, and the incidence of these adverse reactions was simi,lar in the two groups. The rate of bone marrow depression in the combined treatment group was higher than that in the drug group, and was mainly grade 1 - 2,which caused no treatment - related deaths. Conclusion EGFR - TKI combined with concurrent radiotherapy is effective and safe for EGFR mutant type advanced non - squamous lung cancer patients.

关 键 词：表皮生长因子受体酪氨酸激酶抑制剂 调强放疗 晚期肺癌/同步治疗 

分 类 号：R734.2[医药卫生—肿瘤]