吉非替尼与化疗交叉应用于EGFR敏感突变型晚期非小细胞肺癌一、二线治疗的效果观察  

Cross application of gefitinib and chemotherapy in the treatment of EGFR-mutation-positive advanced non-small cell lung cancer

作　　者：劳逸[1] 黄潞[1] 王辉[1] 丁玲[1] 李明[1] 谢馨[1] 陈康彪[1] 吴业 叶妍妍 黄康淼 LAO Yi;HUANG Lu;WANG Hui;DING Ling;Li Ming;XIE Xin;CHEN Kang-biao;WU Ye;YE Yan-yan;HUANG Kang-miao(Department of Oncology,Nongken Central Hospital of Guangdong,Zhanjiang 524002,China)

机构地区：[1]广东省农垦中心医院肿瘤内科化疗四区,广东湛江524002

出　　处：《广东医科大学学报》2018年第2期207-210,共4页Journal of Guangdong Medical University

摘　　要：目的观察吉非替尼与化疗在EGFR敏感突变型晚期非小细胞肺癌患者中一线和二线交叉运用的临床疗效。方法 61例EGFR突变型晚期非小细胞肺癌的初治患者随机分为观察组(31例,一线予以吉非替尼治疗、二线予以化疗)和对照组(30例,一线予以化疗、二线予以吉非替尼治疗)。对比两组的疗效及客观缓解率(ORR)、疾病控制率(DCR)、总生存期(OS)、肿瘤无进展生存期(PFS)与中位无进展生存期(mPFS)。结果两组一、二线治疗后临床疗效的差异均无统计学意义(均P>0.05)。一线治疗后,观察组ORR高于同期的对照组,mPFS较对照组长(14.52个月vs 8.3个月,P=0.010);而二线治疗后,观察组ORR低于同期的对照组(P<0.05),mPFS较对照组的短(7.0个月vs 13.22个月,P=0.041)。两组的中位OS差异无统计学意义(24.63个月vs 21.26个月,P=0.738)。结论一线运用吉非替尼治疗EGFR敏感突变的晚期非小细胞肺癌疗效优于采用化疗者,但吉非替尼与化疗在EGFR突变的晚期非小细胞肺癌的一线与二线交叉运用的序贯方式患者OS上的差异不显著。Objective To observe the clinical effect of gefitinib and chemotherapy as first-and second-line treatment for patients with EGFR-mutation-positive advanced non-small cell lung cancer. Methods 61 patients with EGFR-mutationpositive advanced non-small cell lung cancer in initial treatment were randomly divided into Observation Group（31 cases）and Control Group（30 cases）. Observation Group was treated with the gefitinib as the first-line and chemotherapy as the second-line while Control Group was treated with the chemotherapy as the first-line and gefitinib as the second-line. The two groups were compared in terms of curative effect, objective remission rate（ORR）, Disease Control Rate（DCR）, overall survival（OS）, progress-free survival（PFS） and median progression free survival（mPFS）. Results There was no statistical difference in the clinical curative effect between the two groups after the first-line and second-line treatment（P〉0.05 for all）.After first-line treatment, compared with Control Group, Observation Group had a higher ORR and longer mPFS（14.52 months vs 8.3 months, P=0.010）; However, after second-line treatment, compared with Control Group, Observation Group had a lower ORR（P〈0.05） and shorter mPFS（7.0 months vs 13.22 months, P=0.041）. However, there was no difference in OS between the two groups（24.63 months vs 21.26 months, P=0.738）. Conclusion The first-line application of gefitinib in the treatment of EGFR-mutation-positive advanced non-small cell lung cancer is superior to the first-line application of chemotherapy. However, there is no significant difference in OS between different sequences of the application of gefitinib and chemotherapy as the first-line and second-line treatment for EGFR-mutation-positive advanced non-small cell lung cancer.

关 键 词：EGFR-TKI 化疗 吉非替尼 靶向治疗 非小细胞肺癌 一线治疗 二线治疗 

分 类 号：R734.2[医药卫生—肿瘤]