晚期肺腺癌患者EGFR-TKI治疗耐药后治疗策略临床研究

Clinical Study of Treatment Strategy for EGFR-TKI Resistant Patients after Advanced Lung Adenocarcinoma

目的对EGFR-TKI治疗进展后不同治疗策略的生存期和疗效进行探讨。方法以该院2016年1—12月接诊的67例EGFR-TKI治疗后出现进展且接受后续治疗的晚期肺腺癌患者为对象,对其实施放疗治疗的同时,给予不同的进展后首次治疗策略,8例为EGFR-TKI联合化疗组,8例为继续EGFR-TKI治疗组,51例为单纯化疗组,分析各组生存期与疗效。结果 67例患者在EGFR-TKI进展后未得到完全缓解,总客观缓解率(ORR)为2.99%,总疾病控制率(DCR)为50.75%;继续EGFR-TKI组DCR为75.00%,EGFR-TKI联合化疗组DCR为62.50%,单纯化疗组为45.10%差异有统计学意义(P<0.05);EGFR-TKI联合化疗组平均无进展生存期(PFS)为3.3个月,继续EGFR-TKI治疗组平均PFS为3.0个月,单纯化疗组平均PFS为2.0个月差异无统计学意义(P>0.05);EGFRTKI联合化疗组平均总生存期(OS)为11.5个月,继续EGFR-TKI治疗组平均OS为6.9个月,单纯化疗组平均OS为8.8个月,BSC组平均OS为0.9个月差异有统计学意义(P<0.001)。结论初次EGFR-TKI治疗后,部分晚期肺腺癌患者耐药后仍然可在EGFR-TKI治疗中受益。

Objective This paper tries to investigate the survival and efficacy of different treatment strategies on EGFR-TKI treatment.Methods 67 cases of EGFR-TKI treated in this hospital from January 2016 to December 2016 with advanced lung adenocarcinoma after the progress and follow-up treatment were selected as the objects,the implementation of radiotherapy treatment was implemented at the same time,the different progress after the first treatment strategy was given,8 cases of EGFR-TKI combined with chemotherapy group,8 cases of EGFR-TKI treatment group,51 cases of chemotherapy group,survival and curative effect were analyzed.Results 67 patients in the EGFR-TKI progression did not get complete remission,the total response rate(ORR)was 2.99%,the total disease control rate was 50.75%(DCR);group EGFR-TKI of DCR was 75.00%,EGFR-TKI chemotherapy group DCR was 62.50%,the pure chemotherapy group was 45.10%the difference was statistically significant(P<0.05);EGFR-TKI chemotherapy group average progression free survival(PFS)for 3.3 months,the EGFR-TKI treatment group average PFS was 3 months,the average PFS chemotherapy group was 2 months there was no statistically diffirence(P>0.05);EGFR-TKI chemotherapy group(median overall survival OS)for 11.5 months,EGFR-TKI treatment group average OS was 6.9 months,the average OS chemotherapy group was 8.8 months,BSC group average OS was 0.9 months the difference was statistically significant(P<0.001).Conclusion After primary EGFR-TKI treatment,patients with advanced adenocarcinoma of the lung are still able to benefit from EGFR-TKI treatment after resistance.