河北医学2024，Vol.30Issue(11)：1907-1912,6.DOI:10.3969/j.issn.1006-6233.2024.11.029
晚期NSCLC患者接受吉非替尼靶向联合化疗治疗疗效及无进展生存预测因子研究
Efficacy of Gefitinib Targeted Therapy Combined with Chemotherapy and Predictors of Progression-Free Survival in Patients with Advanced NSCLC
摘要
Abstract
Objective:To investigate the efficacy of gefitinib targeted therapy combined with chemother-apy in patients with advanced non-small cell lung cancer(NSCLC)and to analyze the predictors of progres-sion-free survival(PFS).Methods:The clinical data of 255 patients with advanced NSCLC who were diag-nosed and treated in the hospital were retrospectively analyzed from January 2019 to December 2021.The a-bove subjects were divided into control group(n=78)and combined group(n=177)by the treatment meth-ods.The control group was treated with conventional chemotherapy,while the combined group received ge-fitinib targeted therapy combined with chemotherapy.The short-term efficacy was compared between the con-trol group and the combined group.Kaplan-Meier was used to draw the PFS survival curve of the two groups to evaluate the long-term efficacy.Univariate analysis and multivariate COX regression analysis were used to analyze the predictors of PFS in the combined group.Results:Compared with the control group,the objective response rate(ORR)(68.36％vs 55.13％)and disease control rate(DCR)(97.14％vs 87.18％)in the combined group were higher(P<0.05).The median PFS in the combined group was 14 months and that in the control group was 9 months.Log-rank test revealed that the survival curve in the two groups was different(95％CI:1.12～2.17,Log-rank test χ2=7.624,P=0.006).Univariate analysis suggested that age,pleu-ral effusion,bone metastasis,epidermal growth factor receptor(EGFR)mutation,tumor staging,tumor diam-eter,lactate dehydrogenase(LDH)level and short-term efficacy were correlated with PFS(P<0.05).Multi-variate COX regression analysis revealed that pleural effusion(95％CI:1.025～1.166),EGFR mutation(95％CI:1.018～1.067),tumor stage ⅣA-ⅣB(95％CI:1.021～1.140),tumor diameter≥5cm(95％CI:1.039～1.159),LDH>245U/L(95％CI:1.055～1.150)and optimal efficacy(95％CI:1.548～4.752)were independent predictors of PFS(P<0.05).Conclusion:Gefitinib targeted therapy combined with chemotherapy has a good short-term effect in the treatment of advanced NSCLC,and can effectively improve the long-term prognosis of patients.Pleural effusion,tumor staging,tumor diameter,LDH level and optimal efficacy are independent predictors of PFS in patients with advanced NSCLC receiving gefitinib targeted thera-py combined with chemotherapy.关键词
非小细胞肺癌/吉非替尼/靶向治疗/化疗/无进展生存/预测因素Key words
Non-small cell lung cancer/Gefitinib/Targeted therapy/Chemotherapy/Pro-gression-free survival/Predictors引用本文复制引用
仝雪霞,关文霞,李芳,张瑞..晚期NSCLC患者接受吉非替尼靶向联合化疗治疗疗效及无进展生存预测因子研究[J].河北医学,2024,30(11):1907-1912,6.基金项目
宁夏自然科学基金项目,(编号:2021AAC03390) （编号:2021AAC03390）
2023年宁夏医科大学总医院国家自然科学基金孵育计划项目,(编号:YJXM20240001) （编号:YJXM20240001）
