一代EGFR-TKI联合同步放疗治疗EGFR-TKI耐药晚期肺腺癌患者的有效性和安全性

Efficacy and safety of continuous EGFR-TKIs administration combined with concurrent radiotherapy in local progressed advanced lung adenocarcinoma patients previously treated with the first EGFR-TKIs

目的:探索第一代EGFR酪氨酸激酶抑制剂(EGFR-TKI)耐药后继续口服EGFR-TKI并联合局部放疗治疗晚期肺腺癌的有效性和安全性。方法:回顾性纳入2014年1月至2017年7月期间本中心符合纳入标准的、接受第一代EGFR-TKI联合局部放疗治疗的晚期肺腺癌患者,分析其疗效及不良事件发生情况。结果:研究纳入了64例符合纳入标准及排除标准的患者,继续口服原EGFR-TKIs并联合局部放疗的平均PFS为(5.48±3.85)个月。PFS与患者进展病灶不同数量相关,出现1、2、3个病灶进展患者的无进展生存期分别为6.60个月、5.17个月和2.82个月,组间比较有显著统计学差异(P=0.006)。继续口服原EGFR-TKIs并联合局部放疗总体3-4级不良事件发生率为10.9%。结论:第一代EGFR-TKI联合局部放疗是EGFR-TKI治疗晚期肺腺癌后局部进展的有效治疗方式之一。

Objective: To investigate the effectiveness and safety of continuous EGFR-TKIs administration combined with concurrent radiotherapy after local progression in advanced lung adenocarcinoma patients previously treated with the first EGFR-TKIs. Methods: EGFR-mutant advanced NSCLC patients in accord with the inclusion criteria who were treated with previous EGFR-TKIs and assessed as local progression were retrospectively included from January 2014 to July 2017. Efficacy and safety information were recorded and analyzed. Results: 64 patients in accord with the inclusion criteria and the exclusion criteria were included. Continuous EGFR-TKIs administration combined with concurrent radiotherapy could got a progression-free survival( PFS) of 5. 48 months. PFS was significantly associated with the number of progressed lesions( median PFS:1 vs 2 vs 3 progressed lesions = 6. 60 vs 5. 17 vs 2. 82 months). There was a statistically significant difference between the groups( P = 0. 006). The overall 3-4 grade adverse event of this treatment was 10. 9%. Conclusion:Continuous EGFR-TKIs administration combined with concurrent radiotherapy after local progression is a efficient treatment in advanced non-small cell lung cancer patients previously treated with the first EGFR-TKIs.