二线吉非替尼对不同表皮生长因子受体突变点位晚期非小细胞肺癌患者疗效及生存情况的影响  

Effect of second-line gefitinib on efficacy and survival of advanced non-small cell lung cancer patients with different epidermal growth factor receptor mutation sites

作　　者：蔡宏凤 徐宏斌 CAI Hongfeng;XU Hongbin(Department of Critical Care Medicine,the First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710089,Shaanxi,China)

机构地区：[1]西安交通大学第一附属医院(东院)重症医学科,西安7100890

出　　处：《癌症进展》2021年第13期1338-1340,1344,共4页Oncology Progress

摘　　要：目的探讨二线吉非替尼对不同表皮生长因子受体(EGFR)突变点位晚期非小细胞肺癌(NSCLC)患者疗效及生存情况的影响。方法选取72例晚期NSCLC患者,按照不同EGFR突变点位分为两组,EGFR19外显子缺失35例为观察组,EGFR21外显子缺失37例为对照组,比较两组患者二线吉非替尼治疗的临床疗效、不良反应及生存情况。结果观察组患者疾病控制率(DCR)、客观缓解率(ORR)分别为62.86%(22/35)、60.00%(21/35),均高于对照组的37.84%(14/37)、35.14%(13/37),差异均有统计学意义(χ~2=4.504、4.462,P=0.034、0.035)。两组患者不良反应发生率比较,差异均无统计学意义(P﹥0.05)。观察组患者中位无进展生存期(PFS)为28.00个月(95%CI:17.60~38.40),优于对照组的13.00个月(95%CI:8.25~17.75),差异有统计学意义(χ~2=4.033,P=0.045);观察组患者的中位总生存期(OS)为28.00个月(95%CI:20.55~35.45),优于对照组的15.00个月(95%CI:10.23~19.77),差异有统计学意义(χ~2=4.419,P=0.036)。结论二线吉非替尼治疗晚期NSCLC的疗效显著,与EGFR21外显子缺失相比,EGFR19外显子缺失治疗表现出更高的敏感性,OS、PFS更优。EGFR突变状态有助于预测晚期NSCLC接受吉非替尼治疗的效果及生存情况。Objective To investigate the effect of second-line gefitinib on efficacy and survival of advanced nonsmall cell lung cancer(NSCLC)patients with different epidermal growth factor receptor(EGFR)mutation sites.Method A total of 72 patients with advanced NSCLC were divided into two groups according to the different EGFR mutation sites,35 cases of EGFR19 exon deletion in the observation group,37 cases with EGFR21 exon deletion in the control group.The efficacy,survival and adverse reactions of two groups of patients treated with second-line gefitinib were compared.Result The disease control rate(DCR)and objective response rate(ORR)of the observation group were 62.86%(22/35)and 60.00%(21/35)respectively,higher than 37.84%(14/37)and 35.14%(13/37)of the control group,the differences were statistically significant(χ^(2)=4.504,4.462;P=0.034,0.035).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The median progression free survival(PFS)of the observation group was 28.00 months(95%CI:17.60-38.40),better than 13.00 months(95%CI:8.25-17.75)of the control group,the difference was statistically significant(χ^(2)=4.033,P=0.045).The median overall survival(OS)of the observation group was 28.00 months(95%CI:20.55-35.45),better than 15.00 months(95%CI:10.23-19.77)of the control group,the difference was statistically significant(χ^(2)=4.419,P=0.036).Conclusion Second-line gefitinib has a significant effect on advanced NSCLC.Compared with exon deletion of EGFR21,treatment with exon deletion of EGFR19 showed higher sensitivity,superior OS and PFS.EGFR mutation status helps predict the outcome and survival of advanced NSCLC treated with gefitinib.

关 键 词：吉非替尼 表皮生长因子受体 突变 非小细胞肺癌 疗效 总生存期 无进展生存期 

分 类 号：R734.2[医药卫生—肿瘤]