吸烟状况对厄洛替尼治疗晚期非小细胞肺癌疗效影响

The Impact of Smoking Status on the Efficacy of Erlotinib in Patients with Advanced Non-small Cell Lung Cancer

背景与目的厄洛替尼(erlotinib)是治疗晚期非小细胞肺癌的有效靶向药物之一,吸烟状况可能是影响厄洛替尼疗效的因素之一,本研究旨在探讨吸烟状况对厄洛替尼治疗晚期非小细胞肺癌的疗效影响。方法对接受过1个周期以上含铂化疗方案失败的晚期非小细胞肺癌患者,每天口服150mg厄洛替尼直至疾病进展,观察不同吸烟状况患者使用厄洛替尼治疗的疗效、生存时间。采用Kaplan-Meier法分析比较两组间生存率差异。结果2005年12月-2006年9月,共有48例入组厄洛替尼EAP(Expanded Acess Program)项目,随访截止至2008年12月08日,中位随访时间为30个月。患者依从性为100%。吸烟组共有28例,有效率为32.1%(9/28),非吸烟组有20例,有效率为35%(7/20),吸烟组与非吸烟组之间有效率差异无统计学意义(P=0.836)。采用Kaplan-Meier法比较不同吸烟状况间的无进展时间、总生存时间差异:吸烟组中位无进展时间为3个月,非吸烟组中位无进展时间为9个月,两组之间差异有统计学意义(P=0.033);吸烟组中位生存时间为5个月,非吸烟组中位生存时间为17个月,两组之间差异无统计学意义(P=0.162)。结论对于不同吸烟状况的晚期非小细胞肺癌患者,厄洛替尼均有效,且对于非吸烟患者,无进展生存时间较长,差异有统计学意义。

Background and objective Erlotinib is a targeted treatment for advanced non-small cell lung cancer.Smoking status may be one of influencing factors of the efficacy of erlotinib.The aim of this study is to explore the impact of smoking status on the efficacy of erlotinib in patients with advanced non-small cell lung cancer.Methods Patients with non-small cell lung cancer who had been previously treated with at least one course of platinum based chemotherapy received 150 mg oral doses of erlotinib once daily until disease progression.Response rate,progression-free survival,overall survival were analyzed in the different smoking status groups.Kaplan-Meier method was used to analyze the survival rate.Results Forty-eight patients were enrolled into the study from December 2005 to September 2006.We followed up these patients until 28th December,2008.Median follow up time was 30 months.The compliance rate was 100%.The response rate was 32.1% in the smoking group and 35% in the never smoking group （P=0.836）;The median progression-free survival was 3 months and 9 months,respectively （P=0.033）.The median overall survival was 5 months and 17 months,respectively （P=0.162）.Conclusion Erlotinib is an effective drug for advanced non-small cell lung cancer patients with different smoking status.Progression-free survival is better in the never smoking patients than the smoking patients.