埃克替尼治疗EGFR不同突变类型晚期肺腺癌的疗效分析  

Analysis of the efficacy of icotinib in the treatment of advanced lung adenocarcinoma with different mutation types of EGFR

作　　者：朱金秀 谢强 乐雨银 钟爱虹 ZHU Jinxiu;XIE Qiang;LE Yuyin;ZHONG Aihong(Department of Oncology,Fuzhou Pulmonary Hospital,Fujian Fuzhou 350008,China)

机构地区：[1]福建省福州肺科医院肿瘤科,福建福州350008

出　　处：《现代肿瘤医学》2021年第6期961-964,共4页Journal of Modern Oncology

基　　金：福州市临床医学中心资助项目(编号:2018080305)。

摘　　要：目的:回顾分析埃克替尼一线治疗EGFR不同突变类型肺腺癌患者的疗效是否存在差异。方法:收集福州肺科医院2016年01月至2017年12月确诊EGFR突变肺腺癌患者79例,EGFR 19外显子缺失33例,21外显子突变46例,均予口服“埃克替尼125 mg tid”治疗,进行生存期随访;应用χ^(2)检验比较临床特征及临床疗效,应用Kaplan-Meier及Log-Rank法比较生存曲线。结果:19外显子组和21外显子组患者在性别、年龄、吸烟、脑转移、TNM分期、病理分化临床特征无差异(P>0.05);19外显子组和21外显子组ORR(75.8%vs 71.7%)和DCR(97%vs 93.5%)无统计差异(P>0.05);EGFR 19外显子组和21外显子组中位PFS(14.5个月vs 11个月)差异有统计学意义(χ^(2)=4.112,P=0.043);二者中位OS(26个月vs 17个月)差异有统计学意义(χ^(2)=6.650,P=0.010)。结论:晚期肺腺癌EGFR 19外显子缺失较21外显子突变相比EGFR-TKI靶向治疗具有生存获益优势。Objective:To analyse whether there is a difference between the efficacy of first-line treatment of icotinib in patients with different types of EGFR mutations lung adenocarcinoma.Methods:We collected 79 patients with advanced EGFR mutation lung adenocarcinoma in Fuzhou Pulmonary Hospital between January 2016 to December 2017.Among them,there were 33 cases of exon 19 deletion and 46 cases of exon 21 mutation.They all were treated with"icotinib 125 mg tid"orally and followed up for survival.χ^(2)test was used to compare clinical features and clinical efficacy between the two groups.Kaplan-Meier and Log-Rank methods were used to compare survival curves.Results:There was no difference in the clinical characteristics of patients between exon 19 group and 21 group in gender,age,smoking,brain metastasis,TNM stage,and pathological differentiation(P>0.05).There was no statistical difference in ORR(75.8%vs 71.7%)and DCR(97%vs 93.5%)between exon group 19 and 21 exon group(P>0.05).The difference of median PFS(14.5 months vs 11 months)between EGFR 19 exon group and 21 exon variant group was statistically significant(χ^(2)=4.112,P=0.043).The difference of median OS(26 months vs 17 months)between EGFR 19 exon group and 21 exon variant group was statistically significant(χ^(2)=6.650,P=0.010).Conclusion:Advanced lung adenocarcinoma 19 exon deletion than 21 exon mutation after TKI treatment has survival advantage.

关 键 词：埃克替尼 肺腺癌 表皮生长因子(EGFR) 19外显子缺失 21外显子突变 

分 类 号：R734.2[医药卫生—肿瘤]