贝伐珠单抗联合盐酸厄洛替尼治疗晚期非小细胞肺癌EGFR不同外显子突变的疗效分析

Clinical effect of bevacizumab combined withEGFR-TKI therapy on non-small cell lung cancer patients with different EGFR mutations

目的:探讨贝伐珠单抗联合表皮生长因子受体(EGFR)-酪氨酸激酶抑制剂(EGFR-TKI)盐酸厄洛替尼治疗对EGFR外显子19或21突变晚期非小细胞肺癌(NSCLC)的临床疗效。方法:选取2014年6月至2015年7月重庆市肿瘤医院收治的EGFR突变阳性的晚期NSCLC患者96例,其中EGFR外显子19突变48例,外显子21突变48例,根据治疗方法的不同分别将外显子19突变和外显子21突变患者又分为研究组和对照组,每组24例。对照组单独采用盐酸厄洛替尼片治疗,研究组在对照组的基础上加用贝伐珠单抗治疗。比较两组治疗总有效率、1年生存率以及疾病中位进展时间(TTP),同时比较两组治疗后的生活质量(QOL)评分。结果:外显子19突变或21突变研究组的总有效率、中位TTP、1年存活率及QOL各维度评分均明显高于对照组(P<0.05或P<0.01)。两组患者的不良反应发生率比较差异无统计学意义(P>0.05)。结论:贝伐珠单抗联合盐酸厄洛替尼治疗晚期NSCLC的疗效显著,可有效提高存活率,改善预后,且安全性较好,同时能够明显延长中位TTP。

Objective：To investigate the clinical efficacy of bevacizumab combined with tyrosine kinase inhibitor （TKI） targeted therapy on the treatment of advanced non-small cell lung cancer （NSCLC） patients with epidermal growth factor receptor （EGFR） exon 19 or 21 mutation. Methods： 96 advanced NSCLC patients with EGFR mutation treated in our hospital from June 2014 to July 2015 were enrolled. Of them, 48 cases had EGFR exon 19 mutation and 48 cases had EGFR exon 21 mutation. They were both divided into a study group and a control group, with 24 cases in each group. The patients in the control group received erlotinib hydrochloride tablets only, while those in the study group were treated as the control group with addition of bevacizumab. The total effective rate, 1-year survival rate, median time to progression （TPP） and the quality of life （QOL） scale scores were compared between the control group and the study group. Results： The total effective rate, TPP, 1-year survival rate and QOL scores of patients with EGFR exon 19 or 21 mutation in the study group were significantly higher than those in the control group （P〈0.05 or P 〈0.01）. There was no significant difference in the incidence of adverse reactions between the control group and the study group （P〉0. 05）. Conclusion： Bevaeizumab combined with TKI targeted therapy was effective in the treatment of advanced NSCLC. This combination could increase patients＇ survival rate, improve prognosis and prolong TTP, and was safety.