阿美替尼治疗晚期非小细胞肺癌的效果及其影响因素

Effect and Influencing Factors of Aumolertinib in Advanced Non-small Cell Lung Cancer

目的探讨阿美替尼治疗晚期非小细胞肺癌(NSCLC)患者预后的影响因素。方法选取2020年4月至2022年5月在郑州大学第一附属医院和河南省肿瘤医院住院接受治疗的91例晚期NSCLC患者作为研究对象,回顾性分析其接受阿美替尼靶向治疗的效果和预后以及影响因素。以部分缓解(PR)、疾病稳定(SD)和疾病进展(PD)评判疗效。以生存曲线评价患者预后。应用Kaplan-Meier法绘制生存曲线,应用log-rank法比较不同亚组患者的生存率,运用多因素Cox风险回归模型分析评估各因素对患者预后的影响。结果91例患者中,不同脑转移情况、营养风险评分、营养不良的患者生存率比较,差异有统计学意义(P<0.05),其他各指标组间生存率比较,差异无统计学意义(P>0.05)。有脑转移患者的中位生存时间短于无脑转移患者(P=0.017);存在营养风险患者的中位生存时间短于无营养风险患者(P=0.023);无营养不良患者的中位生存时间长于中重度营养不良患者(P=0.003);T790M阳性和T790M阴性患者累积生存率比较,差异无统计学意义(P=0.830)。阿美替尼治疗2个月后,91例患者中PD、PR和SD患者占比分别为7.7%、23.1%和69.2%。T790M阳性组和T790M阴性组疗效比较,差异无统计学意义(P>0.05)。Cox比例风险回归模型显示脑转移、中重度营养不良和年龄≥70岁是影响预后的独立危险因素(P<0.05)。结论阿美替尼治疗晚期NSCLC的效果确切,影响患者预后的危险因素为脑转移、年龄≥70岁及中重度营养不良。

Objective To investigate the prognostic factors of patients with advanced non-small cell lung cancer(NSCLC)treated with aumolertinib.Methods There were 91 patients with advanced NSCLC hospitalized in the First Affiliated Hospital of Zhengzhou University and Henan Cancer Hospital from April 2020 to May 2022 were selected as the study subjects.The effect,prognosis and influencing factors of patients receiving amitinib targeted therapy were analyzed retrospectively.The efficacy was evaluated by partial response(PR),stability disease(SD)and progressive disease(PD).The prognosis was evaluated by survival curve.Kaplan-Meier method was used to draw the survival curve.Log rank method was used to compare the survival rate of different subgroups of patients,and multivariate Cox risk regression model was used to analyze and evaluate the impact of various factors on the prognosis of patients.Results In 91 patients,the survival rate of patients with different brain metastasis,nutritional risk score and innutrition was statistically significant(P<0.05),while the survival rate of other indicators was not statistically significant(P>0.05).The median survival time of patients with brain metastasis was shorter than that of patients without brain metastasis(P=0.017).The median survival time of patients with nutritional risk was shorter than that of patients without nutritional risk(P=0.023).The median survival time of patients without malnutrition was longer than that of patients with moderate to severe malnutrition(P=0.003).There was no statistical difference in the cumulative survival rate between T790M positive and T790M negative patients(P=0.830).After 2 months of treatment with aumolertinib,PD,PR and SD accounted for 7.7%,23.1%and 69.2%of 91 patients,respectively.There was no statistical difference between T790M positive group and T790M negative group(P>0.05).Cox proportional hazards regression model showed that brain metastasis,moderate and severe malnutrition and age≥70 years old were independent risk factors affecting the prognosis(P<0.05).Conclusion Aumolertinib is effective in the treatment of advanced non-small cell lung cancer.The risk factors affecting the prognosis of patients are brain metastasis,age≥70 years old,and moderate to severe malnutrition.