吉非替尼联合化疗治疗表皮生长因子受体基因突变阳性非小细胞肺癌疗效及生存分析

Effect of EGFR mutations on targeted therapy in treatment of patients with non-small cell lung cancer and prognosis analysis

目的探讨吉非替尼联合化疗治疗表皮生长因子受体(EGFR)基因突变阳性的非小细胞肺癌患者疗效及生存分析。方法选取自2011年12月至2014年12月收治的76例EGFR基因突变阳性的非小细胞肺癌患者为研究对象,采用随机数字表法分为A组(n=38)与B组(n=38)。A组采用单纯化疗治疗;B组给予吉非替尼250 mg/d联合化疗治疗。比较两组患者治疗总有效率、疾病控制率(DCR)、无进展存活时间(PFS)、总存活期(OS)、生活质量(QOL)评分以及不良反应发生情况。结果 B组患者总有效率为71.1%(27/38),高于A组的36.8%(14/38),组间比较,差异有统计学意义(P<0.05)。B组DCR为89.5%(34/38),高于A组的50.0%(19/38),组间比较,差异有统计学意义(P<0.05)。B组患者的PFS为(16.21±1.32)个月,高于A组的(12.21±1.32)个月;B组患者的OS为(29.21±1.32)个月,高于A组的(23.21±1.32)个月,组间比较,差异均有统计学意义(P<0.05)。B组患者的QOL评分为(81.21±1.34)分,高于A组的(60.21±1.62)分,组间比较,差异有统计学意义(P<0.05)。B组不良反应发生率为10.4%(4/38),低于A组的23.6%(9/38),组间比较,差异有统计学意义(P<0.05)。结论针对EGFR基因突变阳性的非小细胞肺癌患者的治疗,采用靶向药物吉非替尼联合化疗治疗效果较好,可延长患者生存时间,减少不良反应。

Objective To investigate the effect of EGFR mutations on targeted therapy in treatment of patients with non-small cell lung cancer and prognosis analysis. Methods A retrospective study was performed on 76 cases patients with non-small cell lung canc- er and EGFR mutation who were admitted from December 2011 to December 2014, Patients were divided into Group A （n = 38） and Group B（n = 38）. Patients in Group A were given single chemotherapy;the others in Group B were treated with chemotherapy com- bined with gefitinib in dosage of 250 mg/day. The total effective rate, the disease control rate （DCR）, progress prove survival （PFS）, the total survival time （ OS）, the quality of life （QOL） and the adverse reactions were compared between the two groups. Results The total effective rate in Group B was 71.1% （27/38） ,which was higher than 36. 8% （14/38） in Group A（P 〈0. 05）. DCR in Group B was 89. 5% （34/38） ,which was higher than 50. 0% （19/38） in Group A（P 〈 0.05）. PFS in Group B was （16.21 ± 1.32） months,which was higher than （12. 21± 1.32） months in Group A;OS in Group B was（29. 21±1.32） months,which was higher than （23.21 ±1.32） months in Group A（P 〈0. 05）. QOL in Group B was （81.21 ± 1, 34） scores whinc was higher than （60. 21 ± 1.62） scores in Group A（P 〈0. 05）. The adverse reaction rate in Group B was 10. 4% （4/38） ,which was lower than 23. 6% （9/38） in Group A（P 〈0, 05）. Conclusion Targeted therapy gefitinib combined with chemotherapy in treatment of patients with non-small cell lung cancer with EGFR mutation can effectively improve the clinical symptoms and prognosis ,reduce the rate of adverse reactions,which is worthy of clinical promotion.