EGFR-TKIs维持治疗晚期肺腺癌的临床效果

Clinical Efficacy of EGFR-TKIs Maintenance Treatment for Advanced Lung Adenocarcinoma

目的探讨EGFR-TKIs维持治疗晚期肺腺癌的疗效。方法选取肺腺癌58例,按治疗方法不同,一线化疗后EGFR-TKIs维持治疗组32例,一线化疗后观察或最佳支持治疗组26例。维持治疗组距末次化疗21 d后,开始口服吉非替尼或厄洛替尼,每8周复查病灶,持续至疾病进展死亡或因不能耐受的不良反应而终止治疗。结果 32例维持治疗组患者中,CR 0例,PR 9例,SD 15例,PD 8例,客观缓解率ORR(CR+PR)为28.1%,疾病控制率DCR(CR+PR+SD)为75.0%。26例观察对照组患者中,CR 0例,PR 2例,SD 9例,PD 15例,客观缓解率ORR(CR+PR)7.7%,疾病控制率DCR(CR+PR+SD)42.3%。维持治疗组与观察组比较,近期疗效ORR、DCR均有统计学差异(P<0.05)。女性疗效高于男性。基因突变阳性有效率55.0%,未知组有效率16.7%,基因敏感突变组疗效显著高于未知组。结论EGFR-TKIs维持治疗晚期肺腺癌的疗效较好,值得临床推广。

Objective To investigate the efficacy of EGFR-TKIs in the treatment of advanced lung adenocarcinoma.Methods 58 patients with lung adenocarcinoma were divided into maintenance treatment group（ 32 cases）,and observation or best supportive treatment group（ 26 cases） after first-line chemotherapy. The maintenance treatment group was given oral gefitinib or erlotinib 21 d after the last chemotherapy,and received detection every 8 weeks until died of disease progression or had intolerable adverse reactions. Results Of the 32 patients in maintenance treatment group,CR was 0,PR 9,SD 15,PD 8,objective remission rate ORR（ CR ＋ PR） was 28. 1%,and disease control rate DCR（ CR ＋ PR ＋ SD） was 75. 0%. In the control group,26 cases were observed,CR 0 cases,PR 2 cases,SD 9 cases,PD 15 cases,objective remission rate ORR（ CR ＋ PR） was 7. 7%,the disease control rate DCR（ CR ＋ PR ＋ SD） was 42. 3%. Maintenance treatment group compared with the observation group,shortterm efficacy of ORR and DCR had statistical difference（ P〈0. 05）. The efficacy of female was higher than that of male. The positive rate of gene mutation was 55%,the efficiency of the unknown group was 16. 7%. Conclusion EGFR-TKIs maintenance treatment is effective for advanced lung adenocarcinoma,and it is worthy of clinical promotion.