吉非替尼结合化疗在复治的晚期非小细胞肺癌中的疗效

Clinical outcome analysis of gefitinib integrated chemotherapy in metastatic or recurrent nonsmall cell lung cancer patients

目的分析吉非替尼结合化疗与单纯化疗比较治疗既往吉非替尼和化疗失败的晚期非小细胞肺癌的临床疗效。方法用配对病例对照研究设计法，在2006年1月至2011年6月间接受吉非替尼结合化疗或单纯化疗的既往吉非替尼和化疗失败的晚期非小细胞肺癌中，共有33对在性别、年龄（〈65岁或≥65岁）、ECOG评分（0—1分或2分）、初次吉非替尼治疗的无进展生存期（4—6个月或〉6个月）、既往化疗方案以及诊断时的肿瘤特征方面相匹配。结果两组患者中位随访时间为14．5个月，吉非替尼结合化疗组与对照组的有效率分别为9．1％和6．5％，疾病控制率分别为39．4％和30．3％，中位总生存期（自首剂吉非替尼始）分别为10．4和7．9个月，中位疾病无进展生存期分别为4．2和3．3个月。结论吉非替尼结合化疗与单纯化疗比较治疗既往吉非替尼和化疗失败的晚期非小细胞肺癌的临床结果无明显差异。

Objective To analyze the clinical outcomes between gefitinib integrated chemotherapy and chemotherapy alone among metastatic or recurrent nonsmall cell lung cancer （ NSCLC ） patients who failed in previous treatment with gefitinib and chemotherapy. Methods A total of 33 pairs patients with metastatic or recurrent NSCLC who had progressed on prior therapies and received gefitinib plus chemotherapy or chemotherapy alone between January 2006 old）, Eastern and June 2011, were matched according to gender （ male vs female ） , age （ 〈 65 vs ≥ 65 years Cooperative Oncology Group （ECOG） performance status （PS） （0 - 1 vs 2 ）, progress free survival （PFS） of gefitinib treatment（4 -6 vs 〉 6 months）, number of previous chemotherapy regime and status of tumor at diagnosis, by using a matched-pair case-control study design. Results 14. 5 months of median follow- up showed that the overall response rates and disease control rates in the integrated-treated and chemotherapy alone groups were 9. 1% versus 6.5% and 39.4% versus 30.3%, respectively. There was no statistically significant difference noted with regard to overall survival （OS） （from first gefitinib therapy to death, median, 10. 4 vs 7. 9 months） and PFS （median, 4.2 vs 3.3 months） between the integrated-treated and chemotherapy alone groups.Conclusions There is no difference in clinical outcomes between integrated treatment and chemotherapy alone in patients with metastatic or recurrent NSCLC who failed in previous treatment with gefitinib and chemotherapy.