厄洛替尼治疗终末期非小细胞肺癌的疗效观察

Efficacy of erlotinib in treatment of end-stage non-small cell lung cancer

目的探讨厄洛替尼治疗终末期(PS评分≥3分)非小细胞肺癌的疗效。方法终末期非小细胞肺癌患者47例,随机分为2组,治疗组25例接受厄洛替尼治疗,对照组22例不接受厄洛替尼治疗和其他放化疗,只接受营养支持、控制疼痛、缓解症状等治疗。观察2组的临床疗效、不良反应、生存期及预后影响因素。结果治疗组疾病控制率为72.0%(18/25),高于对照组的27.3%(6/22),差异有统计学意义(P<0.01);治疗组不良反应皮疹发生率84.0%(21/25),腹泻发生率40.0%(10/25),厌食发生率12.0%(3/25),对照组无不良反应。中位生存期治疗组92d,对照组61 d,差异有统计学意义(P<0.01)。Cox分析表明,性别、年龄、既往化疗次数和化疗方案对疗效影响不大,而病理分型、EGFR突变情况和吸烟史是疗效的影响因素(P<0.05)。结论厄洛替尼可延长终末期非小细胞肺癌患者的生存期,提高疾病控制率。

Objective To investigate the effect of erlotinib in treatment of end -stage （PS score ≥ 3 points） non-small cell lung cancer.Methods 47 cases of end-stage non-small cell lung cancer patients were randomly divided into two groups, treatment group of 25 patients who received erlotinib treatment , the control group with 22 cases are not accepted erlo-tinib therapy and other chemotherapy , only accept nutritional support , control pain, relieve symptoms treatment.The clinical efficacy of the two groups, adverse reactions, survival and prognostic factors were observed .Results The disease control rate was 72.0% （18 /25） in treatment group which is higher than 27.3% （6 /22） in the control group, the difference was statisti-cally significant （ P ＆lt;0.01）; in treatment group, the incidence of rash reaction was 84.0% （21 /25） , the incidence of di-arrhea was 40.0% （10 /25）, anorexia incidence was 12.0% （3 /25）, the control group had no adverse reactions .The medi-an survival in the treatment group was 92 d, control group was 61 d （ P ＆lt;0.01）.Cox analysis showed that gender , age, number of previous chemotherapy and type of chemotherapy had little effect on the efficacy , and pathological type, EGFR mu-tation status and smoking history is curative factors （ P ＆lt;0.05）.Conclusion Erlotinib prolongs survival of end-stage non-small cell lung cancer patients and improve disease control rate .