EGFR-TKI靶向治疗Ⅳ期非小细胞肺癌患者疗效观察及对肺功能的影响

Effect of EGFR-TKI Targeting Therapy on Patients with Stage Ⅳ Non-small Cell Lung Cancer and Its Effect on Lung Function

目的探讨表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth fa ctor receptor-tyrosine kinase inhibito rs,EGFR-TKI)靶向治疗Ⅳ期非小细胞肺癌患者疗效观察及对肺功能的影响。方法选取2018年10月~2020年10月在本院就诊的Ⅳ期非小细胞肺癌患者92例,均接受一线EGFR-TKI靶向治疗联合化疗,即EGFR-TKI靶向治疗联合培美曲塞(培美曲塞二钠)和含铂类(顺铂、卡铂或者奈达铂)方案进行治疗,统计92例Ⅳ期非小细胞肺癌患者疗效、肺功能、生活质量、不良反应。结果92例Ⅳ期非小细胞肺癌患者,其中男性38例,女性54例,年龄25~74岁,中位年龄53岁;CR 0例,PR 64例,SD 18例,PD 10例,ORR 69.57%(64/92),DCR 89.13%(82/92);92例Ⅳ期非小细胞肺癌患者中位PFS为20.32个月(95%CI:18.1~22.3个月);治疗后肺功能指标FEV1/FVC、MVV、FEV1%pred均治疗前提高(P<0.05);生活质量改善66例,改善率为71.74%(66/92),稳定16例,稳定率为17.39%(16/92),降低10例,降低为10.87%(10/92);92例患者治疗后不良反应主要集中Ⅰ度、Ⅱ度、Ⅲ度,Ⅰ度肝功能受损45.65%,皮肤反应26.09%,其次分别为骨髓抑制、胃肠道反应、疲乏;Ⅱ度骨髓抑制20.65%,其次为肝功能受损、胃肠道反应;Ⅲ度不良反应骨髓抑制7.61%,其次为肝功能受损、胃肠道反应。结论EGFR-TKI靶向治疗Ⅳ期非小细胞肺癌患者,疗效理想,可显著促进患者肺功能恢复,安全性较好。

Objective To explore the therapeutic effect of Epidermal Growth Factor Receptor-tyrosine Kinase Inhibitors(EGEG FR-TKI)in the treatment of patients with stage Ⅳ non-small cell lung cancer and its influence on lung function.How:Ninety-two patients with stage Ⅳ non-small cell lung cancer admitted to our hospital from October 2018 to October 2020 received first-line EGEG FR-TKI targeted therapy combined with chemotherapy,that is,EGEG FR-TKI targeted therapy combined with pemetrexed(pemetrexed disodium)and platinum-containing(cisplatin,carboplatin or nedaplatin)regimen.The efficacy,lung function,quality of life and adverse reactions of 92 patients with stage Ⅳ non-small cell lung cancer were analyzed.Results 92 patients with stage Ⅳ non-small cell lung cancer(NSCLC),including 38 males and 54 females,aged 25-74 years,median age 53 years;There were 0 CR cases,64 PR cases,18 SD cases,10 PD cases,69.57%ORR(64/92),89.13%DCR(82/92)cases.The median PFS of 92 patients with stage Ⅳ NSCLC was 20.32 months(95%CI:18.1-22.3 months).After treatment,FEV1/FVC,MVV and FEV1%pred were all increased(P<0.05).The quality of life in 66 cases was improved,the improvement rate was 71.74%(66/92),the stability rate was 17.39%(16/92)in 16 cases,and the reduction rate was 10.87%(10/92)in 10 cases.After treatment,the adverse reactions of 92 patients mainly concentrated inⅠ,ⅡandⅢdegrees,liver function was impaired inⅠdegree 45.65%,skin reaction was 26.09%,followed by bone marrow suppression,gastrointestinal reaction and fatigue.Second degree myelosuppression 20.65%,followed by liver function impairment,gastrointestinal reaction;Myelosuppression was 7.61%of grade III adverse reactions,followed by liver function impairment and gastrointestinal reactions.Conclusion EGEG FR-TKI targeted therapy in patients with stage Ⅳ non-small cell lung cancer has ideal efficacy,and can significantly promote the recovery of lung function in patients with good safety.