放化疗联合酪氨酸激酶抑制剂等综合治疗对老年晚期肺腺癌的疗效

Therapeutic effect of radiotherapy and chemotherapy combined with tyrosine kinase inhibitors on elderly patients with advanced lung adenocarcinoma

目的探讨放化疗联合酪氨酸激酶抑制剂(TKI,吉非替尼)等综合治疗在老年晚期肺腺癌中的治疗效果。方法回顾性分析2017年12月至2019年12月泰州市人民医院收治的30例接受同步放化疗治疗的老年晚期肺腺癌患者资料(对照组),30例接受同步放化疗联合TKI(吉非替尼)治疗的老年晚期肺腺癌患者资料(吉非替尼组)。60例患者均为表皮生长因子受体(EGFR)突变阳性。比较两组患者近期疗效、远期疗效[总生存期(OS)、无病生存期(DFS)]、毒副反应、生存质量(KPS评分)。结果吉非替尼组总缓解率(56.67%)高于对照组(30.00%),差异有统计学意义(P<0.05)。吉非替尼组死亡率(46.67%)低于对照组(73.33%),差异有统计学意义(P<0.05)。吉非替尼组OS[(21.64±6.22)个月]及DFS[(16.57±3.38)个月]较对照组[(16.25±4.21)个月、(13.21±3.25)个月]长,差异有统计学意义(P<0.05)。两组胃肠道反应、放射性肺炎、周围神经毒性、放射性食管炎、骨髓抑制及心血管系统毒性发生例数差异无统计学意义(P>0.05)。放疗结束、治疗6个月吉非替尼组KPS评分[(79.8±4.2)分、(85.5±3.8)分]高于对照组[(74.5±4.9)分、(78.2±5.2)分],差异有统计学意义(P<0.05)。结论同步放化疗联合吉非替尼可改善EGFR突变阳性的老年晚期肺腺癌患者近远期疗效及生存质量,且安全性高。

Objective To investigate the therapeutic effect of combined radiotherapy and chemotherapy combined with tyrosine kinase inhibitors(TKI,gefitinib)in elderly patients with advanced lung adenocarcinoma.Methods The data of 30 elderly patients with advanced lung adenocarcinoma(control group)who underwent concurrent chemoradiotherapy in Taizhou People's Hospital from December 2017 to December 2019 were retrospectively analyzed.Data of elderly patients with advanced lung adenocarcinoma treated with nontinib(gefitinib group).All 60 patients were positive for epidermal growth factor receptor(EGFR)mutations.The short-term effects,long-term effects(PFS and OS),side effects,and quality of life(KPS score)were compared between the two groups of patients.Results The total response rate of the gefitinib group(56.67%)was higher than that of the control group(30.00%),the difference was statistically significant(P<0.05).The mortality rate of the gefitinib group(46.67%)was lower than that of the control group(73.33%),the difference was statistically significant(P<0.05).OS[(21.64±6.22)months]and DFS[(16.57±3.38)months]in the gefitinib group were longer than those in the control group[(16.25±4.21)months,(13.21±3.25)months],the difference was statistically significant(P<0.05).There was no significant difference in the incidence of gastrointestinal reactions,radiation pneumonitis,peripheral neurotoxicity,radiation esophagitis,bone marrow suppression,and cardiovascular system toxicity between the two groups(P>0.05).The KPS score of the gefitinib group[(79.8±4.2),(85.5±3.8)points]higher than the control group[(74.5±4.9),(78.2±5.2)points]after the end of radiotherapy and 6 months of treatment,the difference was statistically significant(P<0.05).Conclusion Concurrent chemoradiotherapy combined with gefitinib can improve the short-term and long-term efficacy and quality of life of elderly patients with advanced lung adenocarcinoma with EGFR mutation,and it has high safety.