中医药延缓第一代EGFR-TKIs耐药时间的优势人群特征的研究

Study of the characteristics of benefit population-based on patients with taking the first generation of EGFR-TKIs and drug resistance prolonged by traditional Chinese medicine

目的探讨中医药延缓第一代表皮生长因子受体酪氨酸酶抑制剂(EGFR-TKIs)的优势人群特征的研究。方法回顾性收集2006年1月—2017年12月于中国中医科学院广安门医院住院治疗且出院后继续于此院门诊行中医药治疗的服用EGFR-TKIs药物的非小细胞肺癌患者。以无进展生存(PFS)时间为主要疗效指标。结果本研究纳入患者90例,中位PFS时间为9.6个月。Kaplan-Meier单因素生存分析发现女性、无吸烟史、无饮酒史、周围型肺癌、腺癌、无肾上腺转移、无肝转移、无肺不张、服用EGFR-TKIs后出现不良反应、肺脾气虚合痰湿瘀阻证患者的PFS时间延长。多因素Cox回归分析发现服用EGFR-TKIs后出现不良反应、周围型肺癌、无肾上腺转移为独立保护因素(P<0.05);肺脾气虚合痰湿瘀阻证与其他证型相比可能为保护因素。结论中医药延缓第一代EGFR-TKIs耐药时间的优势人群特征可能为服用EGFR-TKIs后出现不良反应、周围型肺癌、无肾上腺转移、肺脾气虚合痰湿瘀阻证。

Objective To explore the characteristics of the benefit population-based on patients with taking the first generation of EGFR-TKIs and drug resistance prolonged by traditional Chinese medicine.Methods A retrospective collection of patients with non-small cell lung cancer taking EGFR-TKIs who were hospitalized in Guang′anmen Hospital of Chinese Academy of Chinese Medical Sciences from January 2006 to December 2017 and continued to receive traditional Chinese medicine in the outpatient clinic of this hospital after discharge.Progression-free survival(PFS)time was used as the main efficacy index.Results This study included 90 patients with a median PFS time of 9.6 months.Kaplan-Meier univariate survival analysis showed that PFS time was prolonged in 90 patients with the female,no smoking history,no drinking history,peripheral lung cancer,adenocarcinoma,no adrenal metastasis,no liver metastasis,no atelectasis,adverse reactions after taking EGFR-TKIs,syndrome of qi deficiency of lung and spleen and phlegm and blood stasis.Multivariate Cox regression analysis,found that adverse reactions occurred after taking EGFR-TKIs,peripheral lung cancer,no adrenal metastasis were independent protective factors(P<0.05).Compared with other types of syndromes,syndrome of qi deficiency of lung and spleen and phlegm and blood stasis may be protective factors.Conclusion The characteristics of the benefit population-based on taking the first generation of EGFR-TKIs and drug resistance prolonged by traditional Chinese medicine may be peripheral lung cancer,no adrenal metastasis,syndrome of qi deficiency of lung and spleen and phlegm and blood stasis.