吉非替尼对比培美曲塞联合奈达铂新辅助治疗ⅢA-N2期表皮生长因子受体突变阳性肺腺癌病人的疗效  

The efficacy of gefitinib versus pemetrexed combined with nedaplatin in patients with stageⅢA-N2 EGFR mutation-positive lung adenocarcinoma

作　　者：滕继平 杨志胤[1] 胡晓华 TENG Jiping;YANG Zhiyin;HU Xiaohua(Department of Thoracic Surgery,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School,Shanghai 201900,China)

机构地区：[1]上海交通大学医学院附属第九人民医院胸外科,201900 [2]上海交通大学医学院附属第九人民医院肿瘤科,201900

出　　处：《临床外科杂志》2020年第10期938-942,共5页Journal of Clinical Surgery

摘　　要：目的观察吉非替尼与培美曲塞联合奈达铂新辅助治疗ⅢA-N2期表皮生长因子受体(epidermal growth factor receptor,EGFR)突变阳性肺腺癌病人疗效与安全性。方法2015年1月~2019年5月初诊ⅢA-N2期EGFR突变肺腺癌病人89例,根据治疗用药的不同分为靶向治疗组(40例)与化疗组(49例),分别采用吉非替尼和培美曲塞联合奈达铂治疗;比较两组缓解率、组织学评级有效率、不良反应发生率、手术相关指标、术后并发症发生率以及随访生存率。结果吉非替尼组治疗缓解率和组织学评级有效率均高于化疗组(P<0.05);吉非替尼组皮疹、腹泻、甲沟炎和口腔黏膜炎发生率均高于化疗组(P<0.05),恶心、呕吐和骨髓抑制发生率均低于化疗组(P<0.05),Ⅲ~Ⅳ级不良反应发生率低于化疗组(P<0.05),转氨酶升高、周围神经炎发生率与化疗组无明显差异(P>0.05);两组手术切除率、手术时间、术中出血量及引流管留置时间比较差异无统计学意义(P>0.05);两组术后并发症发生率比较差异无统计学意义(P>0.05);吉非替尼组中位生存时间显著长于化疗组(P<0.05)。结论与化疗比较,新辅助吉非替尼治疗对ⅢA-N2期EGFR突变肺腺癌疗效确切,不良反应轻,中位生存时间显著延长。Objective To observe and compare the efficacy and safety of gefitinib and pemetrexed combined with nedaplatin neoadjuvant in patients with stageⅢA-N2 EGFR mutation-positive lung adenocarcinoma.Methods Eighty-nine patients with stageⅢA-N2 EGFR mutation lung adenocarcinoma who were newly diagnosed in our hospital from January 2015 to May 2019 were randomly divided into a targeted therapy group(40 cases)with Gefitinib and a chemotherapy group(49 cases)with pemetrexed combined with nedaplatin.Some items were compared by the two groups,including the remission rate,effective rate of histological grade,adverse reactions incidence,the levels of surgical-related clinical indicators,postoperative complications rate,and follow-up survival rate.Results The remission rate and effective rate of histological grade of the were higher in the gefitinib group than in the chemotherapy group(P<0.05).The incidence of rash,diarrhea,paronychia,and oral mucositis were higher in the gefitinib group than in the chemotherapy group(P<0.05).The incidence of nausea,vomiting,and myelosuppression were lower in the gefitinib group than in the chemotherapy group(P<0.05),and the incidence of gradeⅢ~Ⅳadverse reactions were lower in the gefitinib group than in the chemotherapy group(P<0.05).There was no statistical difference in the incidence of transaminase increased and peripheral neuritis between the two groups(P>0.05).There was no significant difference in surgical resection rate,operation time,intraoperative blood loss,and drainage tube indwelling time between the two groups(P>0.05).There was no statistically significant difference in the incidence of postoperative complications in the two groups(P>0.05).The median OS was significantly longer in the gefitinib group than in the chemotherapy group(P<0.05).Conclusion Compared with chemotherapy,gefitinib for neoadjuvant therapy in treatment of patients with lung adenocarcinoma harboring EGFR mutant at stageⅢA-N2 stage was effectiveexactly,reduced the incidence of adverse reactions and sign

关 键 词：肺癌 腺癌 表皮生长因子受体 新辅助治疗 化疗 

分 类 号：R734.2[医药卫生—肿瘤]