奥希替尼联合同步放化疗治疗EGFR T790M突变的晚期非小细胞肺癌患者的临床效果

Clinical effect of osimertinib combined with concurrent chemoradiotherapy in the treatment of patients with advanced non-small cell lung cancer with EGFR T790M mutation

目的 探讨奥希替尼联合同步放化疗治疗表皮生长因子受体(EGFR)T790M突变的晚期非小细胞肺癌(NSCLC)患者的临床效果。方法 选取2016年3月至2018年9月本院收治的82例EGFR T790M突变的晚期NSCLC患者,采用随机数字表法将其分为对照组(41例)和观察组(41例)。对照组给予同步放化疗治疗,观察组给予奥希替尼联合同步放化疗治疗。比较两组的治疗效果。结果 观察组的疾病控制率、客观缓解率高于对照组,差异具有统计学意义(P<0.05)。观察组的Ⅰ+Ⅱ级皮疹、胃肠道反应、甲沟炎发生率高于对照组,差异具有统计学意义(P<0.05)。随访2年,观察组的无进展生存时间(PFS)为11.32(6.85,12.41)个月,长于对照组的7.29(4.91,9.32)个月(P<0.05);随访1、2年,观察组的生存率为75.61%、39.02%,高于对照组的56.10%、12.20%,差异具有统计学意义(P<0.05)。结论 奥希替尼联合同步放化疗治疗EGFR T790M突变的晚期NSCLC患者可提高近远期治疗效果,延长PFS,提升患者生存率,具有较高的临床应用价值。

Objective To investigate the clinical effect of osimertinib combined with concurrent chemoradiotherapy in the treatment of patients with advanced non-small cell lung cancer(NSCLC)with epidermal growth factor receptor(EGFR)T790M mutation.Methods A total of 82 patients with advanced NSCLC with EGFR T790M mutation admitted in our hospital from March 2016 to September 2018 were selected and divided into control group(41 cases)and observation group(41 cases)by random number table method.The control group was treated with concurrent chemoradiotherapy,and the observation group was treated with osimertinib combined with concurrent chemoradiotherapy.The therapeutic effects of the two groups were compared.Results The disease control rate and objective remission rate of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).The incidences of gradeⅠ+Ⅱrash,gastrointestinal reaction and paronychia in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After 2 years of follow-up,the progression free survival(PFS)of the observation group was 11.32(6.85,12.41)months,which was longer than 7.29(4.91,9.32)months of the control group(P<0.05);after 1 and 2 years of follow-up,the survival rates of the observation group were 75.61%and 39.02%,which were higher than 56.10%and 12.20%of the control group,and the differences were statistically significant(P<0.05).Conclusion Osimertinib combined with concurrent chemoradiotherapy in the treatment of advanced NSCLC patients with EGFR T790M mutation can improve the short-term and long-term therapeutic effect,prolong PFS and improve the survival rate of patients,it has higher clinical application value.