奥希替尼联合化疗治疗晚期NSCLC患者EGFR基因突变型的近远期疗效

Short-term and long-term efficacy of ositinib combined with chemotherapy in the treatment of advanced NSCLC with EGFR gene mutation

目的:探讨奥希替尼联合化疗治疗表皮生长因子受体(EGFR)基因突变的晚期非小细胞肺癌(NSCLC)的疗效和安全性。方法:按治疗方案不同将80例晚期NSCLC患者(EGFR突变型)分为联合组(n=38)和单药组(n=42),联合组予以奥希替尼联合化疗治疗,单药组予以奥希替尼单药治疗。比较两组近期疗效和无进展生存期(PFS)、总生存期(OS);比较两组血清癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)、血管内皮生长因子(VEGF)和胰岛素样生长因子-1(IGF-1)水平,并记录两组不良反应发生情况。结果:联合组ORR为68.42%,高于单药组的54.76%,但差异无统计学意义(P>0.05)。联合组中位PFS为15.2个月,高于单药组的10.3个月(P<0.05);联合组中位OS为25.1个月,高于单药组的18.2个月(P<0.05)。治疗后,联合组血清CEA、CYFRA21-1和VEGF、IGF-1水平均低于单药组(P<0.05)。两组不良反应均以I~II级为主,但联合组白细胞减少发生率高于单药组(P<0.05);两组其他不良反应发生率比较,差异无统计学意义(P>0.05)。结论:奥希替尼联合化疗治疗晚期NSCLC(EGFR突变型)能有效降低血清肿瘤标志物和IGF-1、VEGF水平,使患者生存获益。

Objective:To investigate the efficacy and safety of ositinib combined with chemotherapy in the treatment of advanced non-small cell lung cancer(NSCLC)with epidermal growth factor receptor(EGFR)gene mutation.Methods:A total of 80 patients with advanced NSCLC(EGFR gene mutation)were divided into combined group(n=38)and single drug group(n=42)according to different treatment methods.The combined group was treated with ositinib combined with chemotherapy,and the single drug group was treated with ositinib alone.Short-term efficacy,progression-free survival(PFS),overall survival(OS),were compared between the two groups.Serum CEA,CYFRA21-1,IGF-1 and VEGF levels were compared between the two groups.The adverse reactions of the two groups were recorded.Results:The ORR of combined group was 68.42%,which was higher than 54.76%of single drug group,but there was no significant difference(P>0.05).The median PFS of the combined group was 15.2 months,which was higher than 10.3 months of the single drug group(P<0.05).The median OS of the combined group was 25.1 months,which was higher than the 18.2 months of the single drug group(P<0.05).After treatment,the serum levels of CEA,CYFRA21-1,IGF-1 and VEGF in the combined group were lower than those in the single drug group(P<0.05).The adverse reactions of the two groups were mainly grade I-II.The incidence of leukopenia in the combined group was higher comparing with the single drug group(P<0.05),there was no statistically significant different in the incidence of other adverse reactions between the two groups(P>0.05).Conclusion:For patients with advanced NSCLC(EGFR gene mutant),oxidtinib combined with chemotherapy can effectively reduce serum tumor markers,IGF-1 and VEGF levels,and benefit the survival of patients.