厄洛替尼治疗EGFR状态未知晚期肺腺癌的疗效观察

Efficacy of erlotinib and PC regimen in treatment of advanced lung adenocarcinoma with unknown EGFR status

目的观察厄洛替尼治疗表皮生长因子受体(EGFR)状态未知晚期肺腺癌的近期疗效与安全性。方法将49例晚期肺腺癌患者随机分成两组:厄洛替尼组24例,给予厄洛替尼150 mg/d口服;化疗组25例,给予一级标准化疗方案。比较两组的近期疗效、毒副反应及生存情况。结果厄洛替尼组总有效率为37.5%,疾病控制率为66.7%,毒副反应主要为Ⅰ~Ⅱ级,包括皮疹、腹泻和呕吐等;化疗组总有效率为32.0%,疾病控制率为64.0%,毒副反应主要为骨髓抑制、胃肠道反应。两组总有效率比较无统计学差异(P>0.05),厄洛替尼组毒性反应发生率明显低于化疗组(P<0.05)。厄洛替尼组中位无进展生存期为8.3个月,中位生存期为10.2个月;化疗组中位无进展生存期为7.1个月,中位生存期为8.4个月,两组比较均无统计学差异(P均>0.05)。结论厄洛替尼治疗EGFR状态未知晚期肺腺癌患者的近期疗效与标准化疗方案相似,且不良反应少,患者耐受性好,可以作为EGFR状态未知的晚期肺腺癌患者的优选方案。

Objective To compare the objective response and toxicity of erlotinib and platinum-based chemotherapy( PC) in the treatment of advanced lung adenocarcinoma with unknown EGFR status and to explore the treatment strategies of advanced lung cancer with unknown EGFR status. Methods Forty-nine cases of patients with advanced lung adenocarcinoma were randomly divided into two groups,the erlotinib group( n = 24) was given erlotinib 150 mg / d orally and the chemotherapy group( n = 25) was given PC regimen. The short-term effects,toxicity and survival of the two groups were compared. Results In the erlotinib group,the total effective rate was 37. 5%,disease control rate was 66. 7%,and mainly toxicities were grade Ⅰ-Ⅱ including rash,diarrhea and vomiting; in the chemotherapy group,the total effective rate was 32. 0%,disease control rate was 64. 0%,and the main toxicities were myelosuppression and gastrointestinal reactions,which were significantly higher than the erlotinib group. No significant difference in the total effective rate was found between the two groups( P > 0. 05),but the toxicity in the erlotinib group was significantly lower than that of the chemotherapy group( P < 0. 05). The median progression-free survival was 8. 3 months,median survival was 10. 2 months in the erlotinib group,and they were seperately 7. 1 months and 8. 4 months in the chemotherapy group( P > 0. 05). Conclusion With less toxicity and good patient tolerance,erlotinib in the treatment of advanced lung adenocarcinoma with unknown EGFR status is not inferior to standard chemotherapy,which may be used as the preferred option of patients.