微波消融联合吉非替尼治疗表皮生长因子受体突变晚期肺腺癌

Microwave ablation combined with Gefitinib for treatment of advanced lung adenocarcinoma with EGFR mutations

目的探讨CT引导下微波消融联合吉非替尼治疗表皮生长因子受体(EGFR)突变晚期肺腺癌的临床效果。方法选取EGFR突变晚期肺腺癌患者110例,随机分为治疗组(n=55)及对照组(n=55),分别给予CT引导下微波消融联合吉非替尼治疗及单纯吉非替尼治疗,比较2组治疗6个月后的临床效果及不良反应。结果治疗6个月后,治疗组完全缓解(CR)12例、部分缓解(PR)32例、稳定(SD)7例、进展(PD)4例,临床有效率为80.00%(44/55),疾病控制率92.73%(51/55);对照组CR 9例、PR 24例、SD 10例、PD 12例,临床有效率为60.00%(33/55),疾病控制率78.18%(43/55);治疗组临床有效率及疾病控制率均高于对照组(P均<0.05)。治疗期间,治疗组出现气胸、咯血、胸痛、发热人数均高于对照组(P均<0.05),但2组腹泻、皮疹、肝功能异常差异均无统计学意义(P均>0.05)。结论CT引导下微波消融联合吉非替尼治疗EGFR突变晚期肺腺癌有效且安全。

Objective To investigate the efficacy of CT-guided microwave ablation combined with Gefitinib for treatment of advanced lung adenocarcinoma with epidermal growth factor receptor(EGFR)mutations.Methods Totally 110 patients with advanced lung adenocarcinoma of EGFR mutations were randomly divided into treatment group or control group(each n=55).All patients were treated with Gefitinib,while those in treatment group were treated with combined CT-guided microwave ablation.Clinical efficacy and adverse reactions were compared between 2 groups 6 months after treatment.Results After 6 months of treatment,complete response(CR)and partial response(PR)were observed in 12 and 32 cases,while stable disease(SD)and progressive disease(PD)were noticed in 7 and 4 cases,respectively,and the effective rate was 80.00%(44/55),the disease control rate was 92.73%(51/55)in treatment group.Meanwhile,CR,PR,SD and PD were found in 9,24,10 and 12 cases,respectively,and the effective rate and disease control rate were 60.00%(33/55)and 78.18%(43/55)in control group.Both effective rate and disease control rate were higher in treatment group than in control group(all P<0.05).During 6 months’treatment,pneumothorax,hemoptysis,chest pain and fever in treatment group were more than in control group(all P<0.05),but there was no significant difference of diarrhea,rash nor hepatic insufficiency between the two groups(all P>0.05).Conclusion CT-guided microwave ablation combined with Gefitinib is safe and effective in treatment of advanced lung adenocarcinoma with EGFR mutations.