EGFR基因突变对靶向治疗非小细胞肺癌患者的疗效影响及生存分析

Effect of EGFR Mutations on Targeted Therapy in the Treatment of Patients with Non-small Cell Lung Cancer and Prognosis Analysis

目的探讨表皮生长因子受体(EGFR)基因不同染色体上外显子突变对靶向治疗非小细胞肺癌患者的疗效影响及生存分析。方法选取76例EGFR基因敏感突变非小细胞肺癌患者,根据EGFR基因检测结果分为四组:A组,EGFR基因18号染色体上外显子突变型组(18例);B组,EGFR基因19号染色体上外显子突变型组(20例);C组,EGFR基因20号染色体上外显子突变型组(19例);D组,EGFR基因21号染色体上外显子突变型组(19例)。同时选取同期住院治疗的20例EGFR基因野生型(EGFR基因未突变)非小细胞肺癌患者作为E组(对照组)。各组患者均给予吉非替尼(250 mg/d)治疗。结果与E组比较,A、B、D组的总有效率和疾病控制率均升高,差异均有统计学意义(P均<0.05);与E组比较,C组的总有效率和疾病控制率均降低,差异均有统计学意义(P均<0.05)。与E组比较,A、B、D组PFS、OS和QOL均升高,差异均有统计学意义(P均<0.05);与E组比较,C组的PFS、OS和QOL均降低,差异均有统计学意义(P均<0.05)。与E组比较,A、B、D组总不良反应发生率均降低,差异均有统计学意义(P均<0.05);与E组比较,C组的总不良反应发生率升高,差异有统计学意义(P<0.05)。结论采用靶向药物吉非替尼治疗EGFR基因18、19和21号染色体上外显子突变的非小细胞肺癌患者效果较好,同时延长患者生存时间,降低不良反应;相反,采用靶向药物吉非替尼治疗EGFR基因20号染色体上外显子突变的非小细胞肺癌患者因出现耐药而效果不佳。

Objective To investigate the effect of EGFR mutations on targeted therapy in the treatment of patients with non-small cell lung cancer and prognosis analysis. Methods 76 cases patients with non-small cell lung cancer and EGFR muta- tion were analyzed,and divided into four groups. A group （ 18 cases） ：patients with non-small cell lung cancer and EGFR mutation in exon 18. B group （20 cases） ：patients with non-small cell lung cancer and EGFR mutation in exon 19. C group （ 19 cases） ：pa- tients with non-small cell lung cancer and EGFR mutation in exon 20. D group （ 19 cases） ：patients with non-small cell lung canc- er and EGFR mutation in exon 21. All patients were treated with gefitinib （250 mg,/d）. After treatment, clinical efficacy, survival and toxicity were compared in all groups. Results Compared with E group, the total effective rate and the disease control rate in A, B and D groups were all higher （ Pall 〈 O. 05 ）. Compared with E group, the total effective rate and the disease control rate in C group were all lower （ Pall 〈 0.05 ）. Compared with E group, the levels of PFS, OS and QOL in A, B and D groups were all higher （ Pall 〈 0.05 ）. Compared with E group ,the levels of PFS, OS and QOL in C group were all lower （ Pall 〈 0.05 ）. Compared with E group, the levels of adverse reactions in A, B and D groups were all lower （Pall 〈 0.05 ）. Compared with E group, the level of adverse reactions in C group was higher （ Pall 〈 0.05）. Conclusion Targeted therapy in the treatment of patients with non-small cell lung cancer with EGFR mutation in exon 18,19,21 can effectively improve the clinical symptoms and prognosis, reduce the rate of adverse reactions. On the contrary, targeted therapy in the treatment of patients with non-small cell lung cancer with EGFR mutation in exon 20 can effectively reduce the clinical symptoms and prognosis, reduce the rate of adverse reactions.