盐酸埃克替尼加倍用量和化疗对靶向治疗后进展的晚期肺腺癌的临床疗效和安全性比较

Comparision of clinical efficacy and safety of icotinib double dose and chemotherapy on the advanced lung adenocarcinoma after targeted therapy

目的比较盐酸埃克替尼加倍用量靶向治疗和培美曲塞加顺铂治疗靶向治疗后进展的晚期肺腺癌的临床疗效及安全性。方法选择44例表皮生长因子受体（EGFR）基因突变且口服埃克替尼125mg／次，3次／d后进展的晚期肺腺癌患者，随机分为A组（埃克替尼加量纽）和B组（培关曲塞加顺铂治疗纽）各22例，比较两组临床疗效和安全性。结果A组有效率为9．1％，疾病控制率为63．6％；B组有效率为27．3％，疾病控制率为77．3％，两组疾病控制率及有效率比较差异未见统计学意义（P〉0．05）。A组主要的不良反应为皮疹，B组不良反应为消化道反应及骨髓抑制，均可耐受，两组不良反应比较差异未见统计学意义（P〉0．05）。结论埃克替尼加量组与培关曲塞组比较，疗效无差异，不良反应较轻。

Objective To compare the clinical effect and safety of icotinib double dose targeted therapy and pemetrexed plus cisplatin in treatment of advanced lung adenocarcinoma after targeted thera- py. Methods Forty-four patients with epidermal growth factor rectpeor （EGFR） gene mutations ad- vanced lung adenocarcinoma after icotinib 125 rag/times, 3 times/day were randomly divided into group A （icotinib group） and group B （pemetrexed group）, and 22 cases in each group. The clinical efficacy and safety of the two groups were compared. Results The effective rate of group A was 9.1%, the dis- ease control rate was 63.6% ; the effective rate of group B was 27.3%, the disease control rate was 77.3 % , there were no significant differences between the two groups （P 〉 0. 05 ）. The main toxic and side effects in group A were rash, and that in the group B was the digestive tract reaction and bone mar- row suppression, which can be tolerated. There was no significant difference in the main toxic and side effects between the two groups （ P 〉 O. 05 ）. Conclusions There is no significant difference in efficacy between ecotinib double dose group and pemetrexed group, but ecotinib double dose group has little toxic and side effects.