1例EGFR驱动基因阳性晚期肺癌患者的综合治疗

Comprehensive Treatment of An Advanced Lung Cancer Patient with EGFR Driver Gene Positive

肺癌的发病率和病死率居全球恶性肿瘤首位,部分患者就诊时已发生远处转移,严重影响生存期及生活质量。随着分子靶向药物的发展,肺癌治疗方式发生变革,精准医疗模式应用临床,不但延长了患者生存期,而且提高了生活质量。本文回顾性分析北京市海淀医院胸外科5年前收治的1例晚期肺癌患者,依据基因检测及循环肿瘤DNA(circulating tumor DNA,ct DNA)变化选择合理治疗方案,并对治疗过程的不良反应进行总结。患者女性,5年前确诊为Ⅳ期表皮生长因子受体(epidermal growth factor receptor,EGFR)驱动基因阳性的非小细胞肺癌,通过靶向药物、靶向药物联合化疗、靶向药物联合抗血管生成药物以及转移灶的放疗,延长生存时间,提高生活质量。本文中EGFR驱动基因阳性的晚期非小细胞肺癌患者,基于精准基因分型以及动态监测,进行个体化治疗,在控制肿瘤的同时,毒副作用反应较为温和。患者生存期得到延长,生活质量得到保证。

Lung cancer is the most common malignant tumor and the leading cause of cancer-related death worldwide.Most of the patients have distant metastasis when visiting the doctor,which seriously affects the survival time and quality of life of the patients.With the development of molecular targeted drugs,lung cancer treatment has been transformed from traditional chemotherapy to targeted therapy and precision medicine has been gradually applied in clinical practice,which can make lung cancer patients live longer and have a better quality of life.We present a case of advanced lung cancer patient who presented to Department of Thoracic Surgery of Beijing Haidian Hospital five years ago.We chose the reasonable treatment options though the genetic tests and circulating tumor DNA tests.We summarized the adverse reactions in the whole course of treatment.The comprehensive therapy we utilized,including targeted therapy,chemotherapy,antiangiogenic agents and local radiotherapy,have resulted in our patient with remaining alive.For advanced non-small cell lung cancer with epidermal growth factor receptor(EGFR)mutation positive,individualized treatment was conducted based on precise genotyping and dynamic monitoring,which can not only control the tumor,but also have mild toxic and side effects.The survival time of the patients was prolonged and the quality of life was guaranteed.