不同一线靶向药治疗晚期表皮生长因子受体突变型非小细胞肺癌的疗效分析  

Analysis of effects of different first-line targeted drugs on advanced EGFR mutant non-small cell lung cancer

作　　者：刘庆玲 林春丽[1] LIU Qing-ling;LIN Chun-li(The Second Department of Oncology,the First People's Hospital of Shangqiu,Shangqiu 476000,Henan,China)

机构地区：[1]商丘市第一人民医院肿瘤二科,河南商丘476000

出　　处：《青岛医药卫生》2023年第2期87-92,共6页Qingdao Medical Journal

基　　金：河南省医疗科技攻关项目,编号2020120212。

摘　　要：目的观察达可替尼、吉非替尼治疗晚期表皮生长因子受体(Epithelial growth factor receptor,EGFR)突变型非小细胞肺癌的临床价值。方法选择2019年1月至2021年5月本院收治的晚期EGFR突变型非小细胞肺癌患者133例为研究对象,根据治疗方案不同分为对照组66例(采用吉非替尼治疗)和观察组67例(采用达可替尼治疗)。两组均连续治疗3个月,治疗后进行为期1年的随访。比较两组近远期病灶改善、肿瘤标志物水平变化、远期生存及药物相关副反应发生情况。结果治疗后,观察组病灶客观缓解率(ORR)、疾病控制率(DCR)高于对照组,组织多肽抗原(TPA)、癌胚抗原(CEA)、鳞癌抗原(SCC)、细胞角蛋白19片段(CYFRA21-1)等肿瘤标志物水平低于对照组,差异有统计学意义(P<0.05);随访期间,观察组中位无进展生存期(PFS)、中位总生存期(OS)均高于对照组,两组药物相关不良反应发生率比较,差异无统计学意义(P>0.05),但观察组毒副反应Ⅰ~Ⅱ级占比高于对照组,Ⅲ~Ⅳ级占比低于对照组,差异有统计学意义(P<0.05)。结论将达可替尼作为一线靶向药治疗晚期EGFR突变型非小细胞肺癌,近远期疗效均优于吉非替尼,且药物副反应更轻,安全性更高。Objective To observe the clinical value of dacomitinib and gefitinib in the treatment of advanced EGFR mutant NSCLC.Methods A total of 133 patients with advanced EGFR-mutant non-small cell lung cancer in our hospital from January 2019 to May 2021 were selected as the research subjects.The patients were divided into the control group(n=66,treated with gefitinib)and the observation group(n=67,treated with dacomitinib)according to different treatment regimens.Both groups were treated for 3 consecutive months,and the two groups were followed up for 1 year after treatment.The improvement of recent and long-term lesions and changes in tumor marker levels were compared between the two groups,and the long-term survival and drug-related side effects were compared between the two groups.Results After treatment,the ORR and DCR of the observation group were higher than those of the control group,and the levels of tumor markers such as tissue polypeptide antigen(TPA),carcinoembryonic antigen(CEA),squamous cell carcinoma antigen(SCC),cytokeratin 19 fragment(CYFRA21-1)were lower than those of the control group(P<0.05).During the follow-up period,the median progression free survival(PFS)and median overall survival(OS)of the observation group were higher than those of the control group.There was no statistically significant difference in the incidence of drug-related adverse reactions between the two groups(P>0.05).However,the proportion of gradeⅠ-Ⅱtoxic reactions in the observation group was higher than that of the control group,and the proportion of gradeⅢ-Ⅳtoxic reactions was lower than that of the control group(P<0.05).Conclusion The short-term and long-term efficacy of dacomitinib as a first-line targeted drug in the treatment of advanced EGFR mutant NSCLC is better than gefitinib.In contrast,dacomitinib has lighter side effects and higher safety.

关 键 词：表皮生长因子受体突变 非小细胞肺癌 吉非替尼 达可替尼 病灶改善 生存情况 药物副反应 

分 类 号：R734.2[医药卫生—肿瘤]