序贯性用药对表皮生长因子受体突变阳性的晚期非小细胞型肺癌患者远期预后的影响

Effect of chemotherapy alternately targeted drugs on the long term prognosis in EGFR mutation positive patients with advanced NSCLC

目的:探讨序贯性用药对表皮生长因子受体(EGFR)突变阳性的晚期非小细胞型肺癌(NSCLC)患者远期预后的影响。方法:选取2012年3月至2013年5月在本院首次接受化疗的80例EGFR突变阳性的晚期NSCLC患者为研究对象。将患者随机分为两组,每组各40例。在治疗过程中,观察组所用药物为吉西他滨+顺铂+吉非替尼,对照组只用吉非替尼。比较两组患者在治疗过程中的耐受情况、不良反应发生率及总缓解率(ORR);经过两年的治疗,比较两组患者癌肿远处转移情况及生存率;评估两组患者的生活质量。结果:耐受情况和不良反应发生率观察组与对照组相比差异无统计学意义,ORR观察组高于对照组(χ2=4.83,P<0.05);1年后远处转移及死亡率观察组均低于对照组(P<0.05);生活质量观察组高于对照组(P<0.05)。结论:序贯性用药虽对EGFR突变阳性的晚期NSCLC患者出现的不良反应无明显的改善作用,但对远期预后有显著作用,并间接提高了患者的生活质量,具有重要的临床应用价值。

Objective ： To investigate the influence of chemotherapy combined with targeted drugs on the long term prognosis in epidermal growth factor receptor （EGFR） mutation positive patients with advanced non-small cell lung cancer（NSCLC）. Methods： Eighty cases in our hospital from March 2012 to May 2013 were selected for this study. The patients were randomly divided into observation group and control group with 40 in each group. The observation group received gemcitabine ＋ cisplatin ＋ gefitinib chemotherapy, while the control group only received gefitinib treatment. The incidence of adverse reaction and drug tolerance of the two groups were compared during the treatment. After two years＇ treatment, the rate of distant metastasis, survival and the quality of life were assessed in the two groups. Results： There was no significant difference between the group in adverse events and drug tolerance, but after two years, the rate of distant metastasis and mortality in the observation group were lower than those in the control group （ P 〈 0. 05 ）. Life quality of patents in the observation group was higher than that in the control group （P 〈 0. 05 ）. Conclusion： Although chemotherapy combined with targeted drugs for EGFR mutation-positive advanced NSCLC patients can＇t significantly reduce the adverse reactions, it can improve the long-term prognosis and life quality of the patients.