盐酸埃克替尼治疗表皮生长因子受体基因敏感突变的晚期非小细胞肺癌的临床效果与临床特征的关系  

Relationship of clinical efficacy of icotinib with clinical features of advanced non-small cell lung cancer patients with epidermal growth factor receptor sensitizing gene mutation

作　　者：于起涛[1] 陈天才 蒋玮[1] 赵文华[1] 

机构地区：[1]广西医科大学附属肿瘤医院呼吸肿瘤内科,南宁市530021

出　　处：《广西医学》2017年第12期1819-1822,1833,共5页Guangxi Medical Journal

摘　　要：目的探讨盐酸埃克替尼治疗表皮生长因子受体(EGFR)基因敏感突变的晚期非小细胞肺癌(NSCLC)的临床效果与临床特征的关系。方法选择EGFR基因敏感突变的晚期NSCLC患者104例,均口服埃克替尼治疗。治疗4周后评价客观缓解率(ORR)及疾病控制率(DCR),随访结束时计算无进展生存期(PFS),分析患者的临床特征与ORR、DCR、PFS的关系;观察不良反应发生情况。结果 104例患者的ORR、DCR分别为48.1%、87.0%。EGFR19号外显子缺失突变、埃克替尼一线治疗和出现皮疹患者的ORR分别高于EGFR 21L858R突变、埃克替尼二线治疗和无皮疹的患者(P<0.05);体力状态评分为0~1分、腺癌、19外显子缺失突变、一线治疗患者的DCR分别高于体力状态评分为2~4分、非腺癌、EGFR 21L858R突变、二线治疗患者(P<0.05)。104例患者中位PFS 10.6个月,体力状态评分0~1分、无吸烟史、EGFR19外显子缺失突变、一线治疗及有皮疹的患者中位PFS分别高于体力状态评分2~4分、有吸烟史、21L858R突变、二线治疗及无皮疹的患者(P<0.05)。治疗相关不良反应主要为皮疹(26.9%)、腹泻(13.4%)和转氨酶升高(9.6%),无需特殊处理。结论埃克替尼治疗EGFR突变晚期NSCLC患者时,不良反应轻微,19外显子缺失突变、治疗期间出现皮疹、一线治疗的患者有更好的近期及远期疗效。Objective To investigate the relationship of clinical efficacy of icotinib with clinical features of advanced non-small cell lung cancer（ NSCLC） patients with epidermal growth factor receptor（ EGFR） sensitizing gene mutation. Methods A total of 104 patients diagnosed as advanced NSCLC with EGFR sensitizing gene mutation were enrolled,and were orally administrated icotinib.Objective response rate（ ORR） and disease control rate（ DCR） were evaluated after four weeks of treatment. Progression-free survival（ PFS） was assessed at the end of follow-up. The relationship of clinical features with ORR,DCR or PFS was analyzed. The incidence of adverse reactions was observed. Results The ORR and DCR of the 104 patients were 48. 1% and 87. 0%,respectively. The ORRs of the patients with exon 19 deletion of EGFR,icotinib as first-line therapy,and rashes were higher than those of the patients with 21 L858 R mutation of EGFR,icotinib as second-line therapy,and without rashes,respectively（ P〈0. 05）. The DCRs of the patients with 0-1 scores of physical status,adenocarcinoma,exon 19 deletion of EGFR,and first-line therapy were higher than those of the patients with 2-4 scores of physical status,non adenocarcinoma,21 L858 R mutation of EGFR,and second-line therapy,respectively（ P〈0. 05）. The median PFS of the 104 patients was 10. 6 months. The PFS of the patients with 0-1 score of physical status,non smoking,exon 19 deletion of EGFR,first-line therapy,and rashes were longer than those of the patients with 2-4 scores of physical status,smoking,21 L858 R mutation of EGFR,second-line therapy,and without rashes,respectively（ P〈0. 05）. The common drug-related adverse reactions were rashes（ 26. 9%）,diarrhea（ 13. 4%） and aminotransferase elevation（ 9. 6%）,and no special treatment was performed in any case. Conclusion Icotinib has mild adverse reactions in the treatment of patients diagnosed as advanced NSCLC with EGFR sensitizing mutation,and it achieves better short-and long-term efficacy f

关 键 词：非小细胞肺癌 埃克替尼 表皮生长因子受体基因 敏感突变 疗效 临床特征 

分 类 号：R734.2[医药卫生—肿瘤]