盐酸埃克替尼治疗晚期肺腺癌的回顾性研究

A retrospective study of icotinib for the treatment of advanced non-small cell lung adenocarcinoma

目的：探讨盐酸埃克替尼治疗晚期肺腺癌的有效性和安全性。方法：利用我院肿瘤患者数据库，回顾性筛选2012年1月–2014年1月于本中心接受盐酸埃克替尼治疗的晚期肺腺癌患者，对符合纳入标准的患者采集年龄、性别、PS评分、肿瘤分期、分子病理改变、用药情况、不良反应等相关临床资料，并对患者进行生存随访。结果：本研究共纳入42例患者，共27例患者接受了EGFR突变基因检测，其中EGFR突变阳性21例。近期疗效方面，RR为38.1%（16/42）；DCR为73.8%（31/42）。中位随访时间为15个月，全组人群中位PFS为14.5个月（95％CI：12.4–16.6个月）。单因素分析显示PFS与年龄、PS评分、治疗前CEA水平、是否放疗、是否脑转移无关（P 〉0.05），而与性别、吸烟状况、EGFR基因突变状况有关。常见的不良反应为皮疹和恶心呕吐，大部分为Ⅰ~Ⅱ度。结论：盐酸埃克替尼治疗晚期肺腺癌临床效果显著，耐受性好，可作为EGFR敏感突变的新选择。

Objective： To evaluate the efficacy and safety of icotinib in patients with advanced non-small cell lung adenocarcinoma. Methods： A total of 42 patients with advanced non-small cell lung adenocarcinoma treated by icotinib from January 2012 to January 2014 in our hospital were collected. The information of the patients that met the included standards in respect of age, gender, PS score, tumor stage, pathological changes, medication, toxicities and so on were collected. Results：Among the 42 patients, 27 patients underwent EGFR mutation detection, and 21 cases were found EGFR mutation. The recent curative effect of RR was 38.1%（16/42） and DCR was 73.8%（31/42）. The median follow-up time was iffteen months. The PFS of the whole group was 14.5 months （95%CI：12.4–16.6 months）. The univariate analysis showed that FPS was more correlated with gender, smoking index, EGFR mutation, rather than age, PS score, CEA levels before treatment, whether radiotherapy and brain metastases or not （P 〉 0.05）. The main toxicities of icotinib were rash, nausea and vomiting which do not need further treatment. Conclusion： The efficacy of icotinib for the treatment of advanced non-small cell lung adenocarcinoma is noble in longer PFS, with better disease control rates and less toxicity. Icotinib could be used as a new choice for the patients with EGFR mutation.