AC方案联合吉非替尼序贯治疗EGFR基因敏感突变的肺腺癌患者的临床疗效观察  

Clinical Observation of AC Regimen Combined with Gefitinib in the Treatment of Lung Adenocarcinoma in Patients with EGFR Gene Mutations

作　　者：陈文福 CHEN Wenfu.(303 Hospital of PLA,Nanning,530021)

机构地区：[1]解放军第三0三医院,530021

出　　处：《实用癌症杂志》2018年第10期1651-1654,1658,共5页The Practical Journal of Cancer

摘　　要：目的研究AC方案联合吉非替尼序贯治疗表皮生长因子受体(EGFR)基因突变的肺腺癌患者的临床疗效及安全性。方法 64例晚期肺腺癌患者随机分为观察组和对照组,观察组患者采用AC方案序贯吉非替尼化疗,对照组患者采用AC方案与吉非替尼同步化疗。根据实体瘤疗效评价标准(RECIST 1. 1)评价疗效,对比两组患者的客观缓解率(ORR)、疾病控制率(DCR)和12个月无进展生存期(PFS),观察并记录患者的不良反应发生情况及严重程度。结果观察组ORR(CR 0例+PR11例)为34. 38%,DCR(CR 0+PR 11+SD 13)为75. 00%,对照组ORR(CR 0+PR 4)为12. 50%,DCR(CR 0+PR 4+SD 10)为43. 75%,观察组ORR和DCR显著高于对照组(P <0. 05)。观察组的PFS为9. 1个月(95%CI为7. 85～10. 35),对照组的PFS为6. 4个月(95%CI为4. 60～8. 20),观察组PFS显著长于对照组(P <0. 05)。两组患者不良反应主要为Ⅰ～Ⅱ级反应,且两组不良反应发生率差异无统计学意义(P> 0. 05)。结论 AC方案序贯吉非替尼对于EGFR基因突变肺腺癌患者,可以有效缓解、控制病情,提高患者生存率,且不良反应较轻。Objective To study the clinical efficacy and safety of AC regimen combined with gefitinib in the treatment of lung adenocarcinoma in patients with EGRR gene mutations. Methods 64 patients with advanced lung adenocarcinoma were randomly divided into the observation group and the control group.Patients of the observation group were treated with AC-sequential sequential gefitinib chemotherapy,while patients of the control group were treated with AC regimen combined with gefitinib chemotherapy.Compared the objective response rate（ORR）,disease control rate（DCR） and 12 months progression-free survival（PFS） of the 2 groups according to the evaluation criteria of solid tumor efficacy（RECIST 1.1）.Observed and recorded the incidence of adverse reactions and severity. Results The ORR（CR 0 cases＋PR 11 cases） was 34.38%,DCR（CR 0 cases＋PR 11 cases＋SD 13 cases） was 75.00% of the observation group,and the ORR（CR 0 cases＋PR 4 cases） was 12.50%,DCR（CR0 cases＋PR4 cases＋SD10 cases） was 43.75% of the control group.The ORR and DCR ofthe observation group were significantly higher than those of the control group（ P〈0.05）.The PFS of the observation group was 9.1 months（95%CI 7.85～10.35） and the PFS of the control group was 6.4 months（95%CI 4.60～8.20）.The PFS of the observation group was significantly longer than that of the control group（ P〈0.05）.The incidence of adverse reactions were mainly grade Ⅰ～Ⅱ,and there was no significant difference between the 2 groups（ P〉0.05）. Conclusion AC sequenced with gefitinib for EGFR gene mutation lung adenocarcinoma,can effectively relieve and control the disease,improve the survival rate with mild side effects.

关 键 词：AC方案 吉非替尼 EGFR基因突变 临床疗效 安全性 

分 类 号：R734.2[医药卫生—肿瘤]