EGFR突变Ⅲa期肺腺癌术后靶向治疗疗效分析

Efficacy of adjuvant EGFR-TKIs therapy in EGFR-mutated stageⅢa lung adenocarcinoma patients

目的:探索第一代EGFR酪氨酸激酶抑制剂用于EGFR突变Ⅲa期肺腺癌患者术后辅助治疗的疗效。方法:回顾性纳入2014年1月至2018年7月期间本中心符合纳入标准的、接受第一代EGFR-TKI治疗的Ⅲa期肺腺癌患者,获取其一般临床数据、无病生存期(disease-free survival,DFS)和不良事件等信息,分析其对预后的影响。结果:研究纳入了80例Ⅲa期EGFR敏感突变患者,其中以T3N1分期(43/80)和19外显子缺失突变(49/80)患者为主。EGFR-TKI平均治疗时间为18.7月。全部患者总体DFS为26.8(24.5~29.1)月,不同的TNM分期之间无统计学差异(P=0.74)。总体Ⅲ-Ⅳ级不良事件发生率为11.25%。结论:Ⅲa期EGFR突变阳性的患者术后采用EGFR-TKI辅助治疗可显著延长DFS,该治疗安全可靠。

Objective:To investigate the effectiveness of first-generation EGFR tyrosine kinase inhibitors on postoperative adjuvant therapy in stageⅢa lung adenocarcinoma patients with EGFR mutation.Methods:StageⅢa lung adenocarcinoma patients meeting the inclusion criteria were retrospectively enrolled from January 2014 to July 2018.General clinical data,disease-free survival(DFS)and adverse events were obtained and analyzed.Results:Eighty patients with stageⅢa EGFR-sensitive mutations were enrolled.Most patients were staged T3N1(43/80)and EGFR 19 exon deletion mutations(49/80)were predominant.The average time of EGFR-TKI therapy was 18.7 months.The median DFS was 26.8 months(24.5~29.1)in all enrolled patients and no significant difference was detected between different TNM stages(P=0.74).The overall incidence of gradeⅢ-Ⅳadverse events was 11.25%.Conclusion:Adjuvant EGFR-TKI therapy in stageⅢa lung adenocarcinoma patients with positive EGFR mutation can significantly prolong DFS,which is safe and reliable.