EGFR突变型转移性非小细胞肺癌的靶向治疗疗效及安全性

Efficacy and safety of targeted therapy in the treatment of metastatic non-small cell lung cancer with EGFR mutation

目的探讨表皮生长因子受体(EGFR)突变型转移性非小细胞肺癌的靶向治疗疗效及安全性。方法选取80例EGFR突变型转移性非小细胞肺癌患者为研究对象,根据治疗方法的不同将患者分为观察组和对照组,每组各40例。对照组采用放射治疗,观察组采用表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)吉非替尼联合放疗治疗,随访5~25个月,比较两组患者治疗4周后的疗效、治疗过程中的不良反应及随访结束时的生存情况。结果治疗4周后,观察组患者的治疗有效率和疾病控制率高于对照组(57.5%vs 35.0%,82.5%vs62.5%),差异均有统计学意义(P<0.05)。两组患者的不良反应均以1~2级为主,观察组患者的不良反应发生率为90.0%(36/40),与对照组的85.0%(34/40)比较,差异无统计学意义(P>0.05)。观察组与对照组患者的中位生存时间分别为15.2个月(95%CI:12.357~18.697)和12.1个月(95%CI:9.354~15.652),差异有统计学意义(χ~2=5.026,P=0.025)。结论对于EGFR突变型转移性非小细胞肺癌,EGFR-TKI靶向治疗可以提高疗效,延长患者的生存时间。

Objective To evaluate the efficacy and safety of targeted therapy in the treatment of metastatic non-small cell lung cancer （NSCLC） with EGFR mutation. Method 80 patients of metastatic NSCLC with EGFR mutation were enrolled in the study, and were administered with radiotherapy （control group, n=40） or EGFR-TKI （gefitinib） combined with radiotherapy （study group, n=40）, after a follow up period of 5-25 months, the curative effect, adverse reactions dur-ing the treatment and the survival of patients at the end of follow-up were compared between the two groups after 4 weeks of treatment. Result After 4 weeks of treatment, the response rate of the study group （57.5%vs 35.0%） and dis-ease control rate （82.5%vs 62.5%） were significantly higher than that of the control group, with statistically significant difference observed （P〈0.05）. The adverse reactions of the two groups were mainly grade I-II, and the incidence of ad-verse reactions in study group was 90.0%（36/40）, compared with 85.0%（34/40） in control group, the difference was of no significant difference （P〉0.05）. The median survival time of the study group and the control group were 15.2 months （95%CI：12.357-18.697） and 12.1 months （95%CI：9.354-15.652） respectively, and were significantly different between the two groups （χ2=5.026, P=0.025）. Conclusion In the treatment of NSCLC with EGFR mutation, EGFR-TKI targeted therapy may improve the efficacy and prolong survival time for patients.