中国医药科学2016，Vol.6Issue(14)：7-12,6.
EGFR-TKI治疗化疗失败后的Ⅳ期NSCLC的疗效及预后分析
Efficacy in stage IV NSCLC after failure of chemotherapy treated with EGFR Tyrosine Kinase Inhibitors
摘要
Abstract
Objective To investigate the efficacy of EGFR-TKIs in the stage IV non-small cell lung cancer patients who had failed chemotherapy,and to observe the influencing factors.Methods 88 patients with cytologically or histologically confirmed stage IV NSCLC who had failed chemotherapy were treated with EGFR-TKIs from January 2012 to January 2015 in Fujian Provincial Tumor Hospital.Data of patient’s characteristics,responses to EGFR-TKIs and survival time were analyzed retrospectively.Collected clinical data were analyzed using SPSS 20.0 software. Results The overall objective response rate (ORR) and the disease control rate (DCR) of 88 patients were 52.3% (46/88) and 90.9% (80/88),respectively.The ORR in patients with ECOG score of 0 to 1 were much higher than those of group which score was 2 and more(83.3% vs 30.8%,P=0.00).The smokers had a lower ORR rate than non-smokers (33.3% vs 60.7%,P=0.011).Among the factors analyzed,sex,age,pathological type,sensitive mutations or mutation status was unknown or the time using EGFR TKI had no significant effect on the clinical benefit rate.The median progression-free survival (PFS) was 10.0 months(95%CI:8.56-11.43月),and the median overall survival (OS) was 25.0 months(95%CI:19.64-30.36月).42 Patients with EGFR Mutation-positive(24Patients with exon 19 deletion,18 Patients with exon 21 mutations),PFS in exon 19 deletion was superior to exon 21 mutations(12.0months vs 8.0months P=0.010).Univariate analysis showed that the influencing factors of PFS and OS were ECOG score and smoking history.PFS and OS in the ECOG score of 0 to 1 were significantly longer than those of group which score was 2 and more(12.0months vs 6.0months P=0.000;40.0 months vs 19.0 months,P=0.000,respectively). PFS and OS in the non-smokers were superior to the smokers(10.0months vs 6.0 monthsP=0.007;30.0months vs 18.0 months,P=0.004,respectively).Multivariate analysis showed that only ECOG score was the independent influencing factors of the PFS and OS (P<0.01).ConclusionEGFR-TKI treatment in Patients with EGFR Mutation-positive or mutations advantage of stage IV NSCLC can benefit in second-lines and above,the curative effect is as much as that of in first-line.ECOG score is independent factors affecting PFS and OS.The ECOG score of 0 to 1 and non-smokers groups have higher ORR rate.There are no statistical difference in ORR,DCR,PFS and OS between the 2nd-line subgroup and >2nd-line subgroup 3.There are no statistical difference in ORR and OS between exon 19 deletion and exon 21 mutations,while the former had much longer PFS.关键词
非小细胞肺癌/EGFR-TKI/靶向治疗/预后Key words
NSCLC/EGFR-TKI/Targeted therapy/Prognosis分类
医药卫生引用本文复制引用
林景辉,林动,徐海鹏,许凌,王强,胡卉华,何晓华,蔡玲玲,何志勇..EGFR-TKI治疗化疗失败后的Ⅳ期NSCLC的疗效及预后分析[J].中国医药科学,2016,6(14):7-12,6.基金项目
吴阶平医学基金会 （）
