放疗、化疗与放化疗联合治疗对非小细胞肺癌患者EGFR基因突变状态的影响比较

Comparison of influence of radiotherapy, chemotherapy and radiation combined with chemotherapy in the treatment of patients with non-small cell lung cancer on the state of EGFR gene mutation

目的 比较放疗、化疗与放化疗联合治疗非小细胞肺癌对表皮生长因子受体（EGFR）基因突变状态的影响.方法 选取非小细胞肺癌患者328例.根据患者具体情况分别给予放疗、化疗及放化疗联合治疗,并根据患者接受治疗方式不同分为化疗组112例,放疗组108例,放化疗组108例.分别在治疗前后对所有患者的血浆EGFR基因突变情况进行检测分析.结果 治疗前化疗组、放疗组、放化疗组血浆中EGFR基因突变率分别为34.82％ （39/112）、31.48％ （34/108）、32.41％ （35/108）,均显著高于治疗后的20.54％ （23/112）、18.52％ （20/108）、19.44％ （21/108）（χ^2=5.709、4.840、4.725,均P〈0.05）.化疗后患者血浆中突变型EGFR基因频率为20.5％ （23/112）,明显低于化疗前突变型EGFR基因频率的34.8％ （39/112）,差异有统计学意义（χ^2 =5.709,P〈0.05）.放疗治疗后,患者血浆中突变型EGFR基因频率为18.5％ （20/108）,明显低于放疗前突变型EGFR基因频率的31.5％ （34/108）,差异有统计学意义（χ^2=4.840,P〈0.05）.放化疗治疗后,患者血浆中突变型EGFR基因频率为19.4％ （21/108）,明显低于放化疗治疗前突变型EGFR基因频率的32.4％ （35/108）,差异有统计学意义（χ^2=4.725,P〈0.05）.结论 放疗、化疗及放化疗治疗非小细胞肺癌均会影响EGFR基因突变状态,且均呈显著性下降.

Objective To compare the influence of radiotherapy,chemotherapy and radiation combined with chemotherapy in the treatment of patients with non-small cell lung cancer on the state of EGFR gene mutation.Methods 328 patients with non-small cell lung cancer were selected.On the basis of the condition of the patients,they were treated with radiation therapy,combination treatment with chemotherapy and radiation.And according to the different treatment methods,they were divided into chemotherapy group （112 cases）,radiotherapy group （108 cases） and radiation combined with chemotherapy group（108 cases）.Before and after treatment,the plasma EGFR mutations situation was detected and analyzed.Results Before treatment,the plasma EGFR mutation rates in the chemotherapy,radiotherapy,radiation combined with chemotherapy group were 34.82% （39/112）,31.48% （34/108）,32.41% （35/108）,which were significantly higher than 20.54% （23/112）,18.52% （20/108）,19.44% （21/108） after treatment（χ^2 =5.709,4.840,4.725,all P 〈 0.05）.The frequency of the mutant EGFR gene in the patients after chemotherapy was 20.5% （23/112）,which was significantly lower than 34.8% （39/112） before chemotherapy,the difference was statistically significant（χ^2 =5.709,P 〈 0.05）.After radiotherapy,the frequency of the mutant EGFR gene in the patients was 18.5 % （20/108）,which was significantly lower than 31.5 % （34/108） before radiotherapy,the difference was statistically significant（χ^2 =4.840,P 〈 0.05）.After chemoradiation therapy,the frequency of the mutant EGFR gene in the patients was 19.4% （21/108）,which was significantly lower than 32.4% （35/108） before chemoradiation therapy,the difference was statistically significant （χ^2 =4.725,P 〈 0.05）.Conclusion Radiotherapy,chemotherapy and radiation combined with chemotherapy in the treatment of non-small cell lung cancer can affect the state of EGFR gene mutation,which has significant decline.