奥希替尼序贯和吉非替尼治疗EGFR突变型晚期非小细胞肺癌近期生存获益的临床研究  

Clinical Study on Short-Term Survival Benefit of Osimertinib Sequential and Gefitinib in the Treatment of EGFR Mutant Advanced Non-Small Cell Lung Cancer

作　　者：张彭辉[1] 边静[1] 李佳佳[1] ZHANG Peng-hui;BIAN Jing;LI Jia-jia(Department of Pharmaceutical Dispensing,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,China)

机构地区：[1]河南科技大学第一附属医院药品调剂科,洛阳471003

出　　处：《中国合理用药探索》2024年第2期56-61,共6页Chinese Journal of Rational Drug Use

摘　　要：目的:探讨奥希替尼序贯和吉非替尼治疗对表皮生长因子受体(EGFR)突变型晚期非小细胞肺癌(NSCLC)患者近期生存获益的影响。方法:回顾性收集2017年7月~2022年7月期间某院收治的150例吉非替尼耐药后EGFR突变型晚期NSCLC患者作为研究对象,将使用奥希替尼序贯治疗的患者纳入序贯组(n=78),使用吉非替尼治疗的患者纳入对照组(n=72)。对照组给予吉非替尼片加量治疗,序贯组给予甲磺酸奥希替尼片序贯治疗,两组均治疗3个疗程。比较两组临床疗效、肿瘤标志物[癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原199(CA199)]水平、生存质量[生存质量核心问卷(QLQ-C30)评分]及不良反应发生情况。结果:治疗后,序贯组治疗总有效率及生存获益率均高于对照组(P<0.05);两组血清CEA、CA125、CA199水平均降低(P<0.05),且序贯组低于对照组(P<0.05);两组QLQ-C30功能评分均升高(P<0.05),且序贯组高于对照组(P<0.05);两组QLQ-C30症状评分均降低(P<0.05),且序贯组低于对照组(P<0.05);两组脱发、白细胞减少、胃肠道症状和肝肾功能异常发生率比较均无统计学差异(P>0.05)。结论:使用奥希替尼序贯和吉非替尼治疗EGFR突变型晚期NSCLC患者临床疗效确切,可有效降低血清肿瘤标志物水平,改善患者生存质量。Objective:To investigate the effect of osimertinib sequential and gefitinib on short-term survival in patients with epidermal growth factor receptor(EGFR)mutant advanced non-small cell lung cancer(NSCLC).Methods:A total of 150 patients with EGFR mutant advanced NSCLC,who developed resistance to gefitinib and admitted to a hospital from July 2017 to July 2022,were retrospectively collected as study subjects.Patients received sequential osimertinib treatment were assigned to the sequential group(n=78),while those received gefitinib treatment were assigned to the control group(n=72).The control group received gefitinib tablets and the sequential group received osimertinib mesylate tablets.Both groups were treated for 3 courses of treatment.The clinical efficacy,levels of tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA199)],quality of life[quality of life core questionnaire-30(QLQ-C30)]and the occurrence of adverse reactions were compared between the two groups.Results:After treatment,the sequential group exhibited higher overall response rate and survival rate compared to the control group(P<0.05).The levels of serum CEA,CA125 and CA199 in both groups decreased(P<0.05),with the sequential group showing lower levels than the control group(P<0.05).The functional score of QLQ-C30 increased in both groups(P<0.05),with the sequential group exhibiting higher scores than the control group(P<0.05).The symptom score of QLQ-C30 was lower in both groups(P<0.05),with the sequential group showing lower scores than the control group(P<0.05).There were no significant differences in the incidence of alopecia,leukopenia,gastrointestinal symptoms and abnormal liver and kidney function between the two groups(P>0.05).Conclusion:Osimertinib sequential gefitinib in the treatment of EGFR mutant advanced NSCLC patients demonstrates significant clinical efficacy,effectively reducing the levels of serum tumor markers and improving the quality of life of patients.

关 键 词：奥希替尼 吉非替尼 序贯治疗 晚期非小细胞肺癌 近期生存 

分 类 号：R541.6[医药卫生—心血管疾病]