吉非替尼治疗EGFR基因突变状态不明的青年晚期肺腺癌疗效分析

Efficacy of Gefitinib for Young Patients with Unknown EGFR Gene Mutation in Advanced Lung Adenocarcinoma

背景与目的肺癌在青年患者中发病率较低,本研究旨在探讨吉非替尼治疗表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor,EGFR)基因突变状态不明青年晚期肺腺癌患者的疗效及生存情况的影响因素。方法对2006年1月-2010年12月在中国医学科学院肿瘤医院接受吉非替尼治疗的55例EGFR基因突变状态不明的青年晚期肺腺癌患者的临床资料进行回顾性分析。结果全组55例患者中位年龄41岁,吉非替尼治疗的客观有效率为43.6%,疾病控制率为90.9%。中位无进展生存期为9.0个月,是否存在脑转移对无进展生存期有明显影响(P=0.017)。中位总生存期为24.0个月,无吸烟史(P=0.028)及进展后是否接受后续治疗(P<0.001)是明显改善总生存期的独立预后因素。结论 EGFR基因突变状态不明的青年晚期肺腺癌患者接受吉非替尼治疗与非年龄选择人群相比疗效相似。

Background and objective Lung cancer in young patients （less or equal to 45 years） is relatively rare. We explored the effcacy and survival of Geiftinib for young patients with unknown epidermal growth factor receptor （EGFR） gene mutation of advanced lung adenocarcinoma. Methods hTe clinical data of 55 young patients with unknown EGFR gene mutation in advanced lung adenocarcinoma referred to the Cancer Hospital＆amp;Institute, Chinese Academy of Medical Sciences from Jan 2006 through Dec 2010 were analyzed retrospectively. Results Of 55 young patients enrolled, the me-dian age was 41 years. hTe objective response rate and disease control rate were 43.6%and 90.9%, respectively. hTe median progression-free survival （PFS） was 9.0 months. Among the factors analyzed, brain metastasis had signiifcant effect on PFS （P=0.017）. hTe median overall survival （OS） was 24.0 months. hTe independent prognostic factors to signiifcantly improve OS included non-smoking history （P=0.028） and receiving other anti-cancer treatment atfer Geiftinib therapy （P〈0.001）. Conclusion hTe median PFS and OS of the young patients with Unknown EGFR gene mutation in advanced lung adeno-carcinoma were similar with general population.