表皮生长因子受体基因突变在晚期非小细胞肺癌维持治疗中的作用

Effect of gene mutations of epidermal growth factor receptor on the maintenance therapy of advanced non-small cell lung carcinoma

目的:探讨表皮生长因子受体(epidermal growth factor receptor,EGFR)基因突变在晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)靶向治疗中的指导意义。方法:对122例既往至少接受过1次含铂类药物化疗达到稳定以上疗效的NSCLC的病理组织行EGFR基因检测,根据检测的结果把患者分为EGFR突变型口服吉非替尼组、EGFR野生型口服吉非替尼组和EGFR野生型多烯紫杉醇化疗组。对3组患者进行临床特征、病理、疗效、生存期、PS评分、不良反应及生活质量的分析。结果:女性、腺癌、吸烟者的EGFR突变率高于对应组;EGFR突变型口服吉非替尼的客观有效率、1年生存率、中位无疾病生存期、中位生存期、PS评分和生活质量优于EGFR野生型口服吉非替尼组;EGFR野生型多烯紫杉醇化疗组的客观有效率、中位无疾病生存期和中位生存期优于EGFR野生型口服吉非替尼组,但1年生存率、PS评分和生活质量无显著差异。结论:表皮生长因子受体基因突变可作为指导晚期非小细胞肺癌维持治疗的重要指标。

Objective： To explore the significance of gene mutations of epidermal growth factor receptor（EGFR） in the targeted therapy of advanced non-small cell lung cancer（NSCLC）.Methods： A total of 122 patients had been treated at least once with platinum-based chemotherapy and became over SD.From their pathological tissues,EGFR genes were extracted and analyzed.Based on the results,theses patients were divided into three groups： EGFR mutation＋per os（p.o.） gefitinib（MpG） group,wild-type EGFR＋p.o.gefitinib（WpG） group,and wild-type EGFR＋docetaxel single therapy（WpD） group.Clinical characteristics,pathology,efficacy,survival time,PS score,toxic side effects and the quality of life were determined in all the patients.Results： The EGFR mutation rates in female patients,adenocarcinoma patients and smokers were higher than those in male patients,non-smokers and non-adenocarcinoma patients.The objective effective rate,1-year survival rate,the median progress free survival time,the median survival time,PS score and the quality of life in the MpG group were advantageous to those in the WpG group.The objective effective rate,the median progress free survival time and the median survival time in the WpD group were advantageous to that of the WpG group,but the 1-year survival rate,PS score and the quality of life were not significantly different.Conclusion： The gene mutations of EGFR can serve as an important indicator to guide the maintenance therapy of advanced non-small cell carcinoma.