晚期NSCLC一线EGFR-TKI治疗缓慢进展后的不同治疗方案分析  

Analysis of Different Treatment Plans after Slow Progression of First-line EGFR-TKI Treatment for Advanced NSCLC

作　　者：杨静欢[1] YANG Jinghuan(Respiratory and Critical Care Medicine Department,Guilin Medical College Affiliated Hospital,Guilin 541001,China)

机构地区：[1]桂林医学院附属医院呼吸与危重症医学科,广西桂林541001

出　　处：《中国医学创新》2024年第31期66-70,共5页Medical Innovation of China

摘　　要：目的:探讨晚期非小细胞肺癌(NSCLC)一线表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)治疗缓慢进展后不同治疗方案的应用效果。方法:回顾性分析2022年3月—2023年12月桂林医学院附属医院收治的84例晚期NSCLC患者。依照治疗方案的不同分为A组(单纯埃克替尼治疗)、B组(单纯化疗)、C组(埃克替尼联合化疗)。比较三组的临床疗效、肿瘤因子指标和毒副反应发生情况。结果:三组疾病控制率比较,差异无统计学意义(P>0.05);治疗后,B组和C组癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)指标均低于A组,差异均有统计学意义(P<0.05)。B组和C组恶心、呕吐与轻度骨髓抑制发生率均高于A组,差异均有统计学意义(P<0.05)。结论:晚期NSCLC一线EGFR-TKI治疗缓慢进展后,给予化疗或给予埃克替尼联合化疗可提升部分疾病控制率,但也会带来恶心、呕吐与轻度骨髓移植等不良反应情况的增加,所以,对耐受性差或高龄患者仍可维持EGFR-TKI治疗,在其耐药后可改为化疗,以克服耐药性。Objective:To investigate the application effect of different treatment plans after the slow progression of first-line epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKI)in advanced non-small cell lung cancer(NSCLC).Method:A retrospective analysis was performed on 84 patients with advanced NSCLC admitted to the Guilin Medical College Affiliated Hospital from March 2022 to December 2023.They were divided into group A(simple Icotinib treatment),group B(simple chemotherapy)and group C(Icotinib+chemotherapy)according to different treatment plans.The clinical efficacy,tumor factors and occurrence of toxic and side effects of the three groups were compared.Result:There was no significant difference in disease control rate among the three groups(P>0.05).After treatment,carcinoembryonic antigen(CEA)and cytokeratin 19 fragment(CYFRA21-1)indexes in group B and group C were lower than those in group A,the differences were statistically significant(P<0.05).The incidence of nausea,vomiting and mild myelosuppression in group B and group C were higher than those in group A,the differences were statistically significant(P<0.05).Conclusion:After the slow progression of first-line EGFR-TKI treatment in advanced NSCLC,chemotherapy or Icotinib combined chemotherapy can improve part of the disease control rate,but it also leads to an increase in adverse reactions such as nausea,vomiting and mild bone marrow transplantation.Therefore,EGFR-TKI treatment can still be maintained for poorly tolerated or elderly patients.After its resistance can be changed to chemotherapy to overcome drug resistance.

关 键 词：非小细胞肺癌 表皮生长因子受体酪氨酸激酶抑制剂 埃克替尼 培美曲塞 

分 类 号：R734.2[医药卫生—肿瘤]