化疗序贯EGFR-TKI治疗晚期非小细胞肺癌EGFR-TKI获得性耐药患者的效果及安全性

Therapeutic efficacy and safety of chemotherapy subsequent EGFR-TKI in advanced non-small cell lung cancer patients with EGFR-TKI acquired resistance

目的 观察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（EGFR-TKI）获得性耐药后应用化疗序贯EGFR-TKI治疗的效果及安全性.方法 回顾分析复旦大学附属中山医院2006年5月至2014年4月收治的36例晚期非小细胞肺癌EGFR-TKI获得性耐药患者的临床特征,其中化疗序贯EGFR-TKI组27例,单用化疗组9例,比较两组的近期疗效、无进展生存时间和不良反应.结果 化疗序贯EGFR-TKI组和单用化疗组的客观缓解率分别为7.4％和0（P=0.557）;疾病控制率分别为81.5％和44.4％ （P =0.046）;中位无进展生存时间分别为3.3和2.5个月（P=0.587）.两组不良反应的发生率差异无统计学意义（P＞0.05）.结论 化疗序贯EGFR-TKI组的疾病控制率高于单用化疗组,但并没有带来生存获益.序贯治疗的不良反应可以接受.

Objective To explore the therapeutic efficacy and safety of chemotherapy subsequent epidermal growth factor receptor-tyrosine kinase inhibitor （EGFR-TKI） in advanced non-small cell lung cancer （NSCLC） patients with EGFR-TKI acquired resistance.Methods The clinical features of 36 advanced NSCLC patients with EGFR-TKI acquired resistance from Affiliated Zhongshan Hospital,Fudan University between May 2006 and April 2014 were retrospectively reviewed.Twenty-seven of them received chemotherapy subsequent EGFR-TKI and another 9 chemotherapy alone.The short-term response,progression-free survival and side effects of two groups were compared.Results The objective response rates of chemotherapy subsequent EGFR-TKI and chemotherapy alone groups were 7.4％ and 0 （P =0.557）,disease control rates 81.5％ and 44.4％ （P =0.046） and median progression-free survival 3.3 and 2.5 months,respectively （P =0.587）.No significant differences existed in the rates of side effects between two groups （P ＞ 0.05）.Conclusions The disease control rates of chemotherapy subsequent EGFR-TKI group are higher than chemotherapy alone group,but there is no survival benefit.And the side effects of subsequent therapy are tolerable.