安罗替尼联合盐酸埃克替尼一线治疗表皮生长因子受体突变阳性非鳞非小细胞肺癌合并脑转移患者的疗效和安全性分析  

Efficacy and safety analysis of anlotinib combined with icotinib hydrochloride in the first treatment of epidermal growth factor receptor mutation positive non squamous non small cell lung cancer patients with brain metastasis

作　　者：杨国青 于法明 李慎柯 姜东亮 YANG Guoqing;YU Faming;LI Shenke;JIANG Dongliang(Basic Medicine School,Xinxiang Medical College,Xinxiang 453000,China;Department of Respiratory,Puyang Oilfield General Hospital,Puyang 457001,China)

机构地区：[1]新乡医学院基础医学院,河南新乡453000 [2]新乡医学院附属濮阳油田总医院呼吸内科,河南濮阳457001

出　　处：《肿瘤基础与临床》2024年第5期510-513,共4页journal of basic and clinical oncology

基　　金：河南省医学科技攻关计划项目(LHGL20200918、LHGJ202009160);濮阳市重大科技专项(220206)。

摘　　要：目的探讨安罗替尼联合盐酸埃克替尼一线治疗表皮生长因子受体(EGFR)突变阳性非鳞非小细胞肺癌合并脑转移患者的疗效和安全性。方法收集2018年6月至2021年11月于濮阳油田总医院就诊的EGFR突变阳性非鳞非小细胞肺癌合并脑转移癌患者61例,采用随机数字表法分为2组,观察组29例应用安罗替尼联合盐酸埃克替尼治疗,对照组32例应用盐酸埃克替尼单药治疗。比较2组患者的疗效、生存及不良反应。结果观察组客观缓解率、疾病控制率均高于对照组(χ^(2)=10.314,P=0.001;χ^(2)=5.710,P=0.017)。观察组颅内病灶客观缓解率、疾病控制率均高于对照组(χ^(2)=4.697,P=0.030;χ^(2)=4.638,P=0.031)。观察组患者中位疾病无进展生存期为10.3个月,(95%CI:9.25~11.35个月),对照组患者为7.4个月(95%CI:5.55~9.26个月;P=0.004)。观察组出现咯血、口腔黏膜炎疼痛、高血压发生率高于对照组(χ^(2)=7.015,P=0.008;χ^(2)=11.663,P=0.001;χ^(2)=14.962,P<0.001)。2组均未发生治疗中断以及与治疗有关的死亡。结论安罗替尼联合盐酸埃克替尼一线治疗EGFR突变阳性非鳞非小细胞肺癌合并脑转移患者可控制颅内病灶,延长疾病无进展生存期,且安全性相对较好。Objective To investigate the efficacy and safety of anlotinib combined with icotinib in the first treatment of epidermal growth factor receptor(EGFR)mutation positive non-squamous non-small cell lung cancer with brain metastasis.Methods From June 2018 to November 2021,61 patients with EGFR mutation positive non-squamous non-small cell lung cancer complicated with brain metastasis in the Puyang Oilfield General Hospital were collected and randomly divided into two groups,and 29 patients in the observation group were treated with anlotinib combined with icotinib,32 patients in the control group were treated with icotinib alone.The efficiency,survival and adverse reactions were compared between the two groups.Results The objective response rate and disease control rate in the observation group were higher than those in the control group(χ^(2)=10.314,P=0.001;χ^(2)=5.710,P=0.017).The objective response rate and disease control rate of intracranial lesions in the observation group were higher than those in the control group(χ^(2)=4.697,P=0.030;χ^(2)=4.638,P=0.031).The median progression-free survival time of patients in the observation group was 10.3 months(95%CI:9.25-11.35 months),while that of patients in the control group was 7.4 months(95%CI:5.55-9.26 months;P=0.004).The incidence of hemoptysis,oral mucositis pain and hypertension in the observation group was higher than that in the control group(χ^(2)=7.015,P=0.008;χ^(2)=11.663,P=0.001;χ^(2)=14.962,P<0.001).No treatment interruption or treatment-related deaths occurred in the two groups.Conclusion Anlotinib combined with icotinib as the first-line treatment for patients with EGFR mutation positive non-squamous non-small cell lung cancer complicated with brain metastasis can control the disease progression,prolong the progression-free survival,and is relatively safe.

关 键 词：非鳞非小细胞肺癌 脑转移 安罗替尼 盐酸埃克替尼 

分 类 号：R734.2[医药卫生—肿瘤]