老年人群晚期非小细胞肺癌患者表皮生长因子受体酪氨酸激酶抑制剂的疗效预测因素分析

Analysis of efficacy associated factors of TKI on old advanced non small cell lung cancer

目的进行老年人群晚期非小细胞肺癌患者表皮生长因子受体酪氨酸激酶抑制剂(TKI)的疗效预测因素分析。方法 98例老年晚期非小细胞肺癌患者,每日口服厄洛替尼150mg 1次,或每日口服吉非替尼250mg 1次,直至病情进展停药,至少1个月以上评价疗效,然后进行分层分析,及单因素和多因素分析。结果分层分析显示,对于治疗的有效率、性别(P=0.0056)、吸烟(P=0.024)、病理类型(P=0.003),均具有统计学差异,而其余因素(P>0.05),无统计学意义。对于疾病控制率、性别(P=0.021)、吸烟(P=0.031)、病理类型(P=0.002)、脑转移(P=0.001),均具有统计学差异;而其余因素(P>0.05),无统计学意义。Logistic回归分析结果,客观有效率结果显示,性别OR=2.01;病理类型OR=3.82;吸烟OR=2.12。其余因素均P>0.05,没有统计学意义。对于疾病控制率结果显示,性别OR=1.78,病理类型OR=2.13,吸烟OR=2.42,脑转移OR=3.67;其余因素均P>0.05,没有统计学意义。结论晚期老年NSCLC的TKI客观有效率与性别、病理类型、吸烟情况有关。疾病控制率与性别、病理类型、吸烟情况、脑转移等因素有关。

Objective To evaluate the efficacy of TKI on the response rate,disease control rate of the patients with advanced non - small cell lung cancer （NSCLC） and to identify the associated factors. Methods Ninety eight patients with advanced samall cell lung cancer received 150mg oral doses of Erlotinib once daily, or received 250mg oral doses of Gefitinib once daily, till disease pro- gression. The clinical efficacy were analyzed b.y DPS software. Results The response rate of TKI in NSCLC by subdivided analysis were gender （ P = 0. 0056 ）, somking （ P = 0. 024 ）, pathology （ P = 0. 003 ）, other factors （ P 〉 0. 05 ）. The disease control rate, gender （ P = O. 021 ）, somking （ P = O. 031 ）, pathology （ P = O. 002）, brain translation （ P = 0. iX） 1 ）, other factors （ P 〉 O. 05 ）. The response rate analysis of Logistic were gender OR = 2.01, somking OR = 2. 12, pathology OR = 3.82, other factors （ P 〉 O. 05 ）. The disease control rate, OR = 1.78, somking OR = 2.42, pathology OR = 2. 13, brain metastases OR = 3.67, other factors （ P 〉 O. 05 ） Conclusion Gender, somking and pathology were prognostic factors of the response rate of TKI in old advanced NSCLC. Gender, somking, pathology and brain metastases were prognostic factors of the disease control rate of TKI in old advanced NSCLC.