表皮生长因子受体酪氨酸激酶抑制剂治疗晚期非小细胞肺癌临床观察

目的评价表皮生长因子受体酪氨酸激酶抑制剂(EGFRT-TKI)治疗晚期非小细胞肺癌(NSCLC)的疗效及安全性。方法晚期NSCLC患者160例使用EGFR-TKI吉非替尼或厄洛替尼治疗,其中77例(48.1%)为一线治疗组,83例(51.9%)为二线治疗组。观测其临床特征、治疗效果及生存时间,并对药物安全性进行评估。结果EGFR—TKI治疗总有效率为33.8%(54/160),疾病控制率为74.4%(119/160)。无进展中位生存时间为9.8个月,中位生存时间为14.5个月,1年生存率为55%。Logistic多因素回归分析显示,病理类型、皮疹情况和血清CEA变化与有效率相关(P均<0.05);病理类型、吸烟史、皮疹情况、血清CEA变化与疾病控制率相关(P均<0.05);病理类型为影响无进展生存的独立因素,PS评分为影响生存的独立因素。一线治疗、二线治疗疗效相当。药物不良反应主要表现为皮疹和轻度腹泻。结论 EGFR—TKI治疗晚期NSCLC安全有效。

Evaluation of epidermal growth factor receptor tyrosine kinase inhibitor to treat patients with advanced non-small cell lung cancer

Objective To investigate the efficacy and safety of epidermal growth factor receptor tyrosine kinase inhibitor（EGFRT-TKI） in treatment of advanced non-small cell lung cancer（NSCLC）.Methods Patients with advanced NSCLC of 160 cases underwent EGFR-TKI gefitinib or erlotinib treatment,of which 77 cases（48.1%） as first-line treatment group,83 cases（51.9%） as second-line treatment group.The clinical features,treatment outcome and survival time were observed,and evaluated the drug safety.Results The total effective rate of ECFR-TKI was 33.8%（54/160）,disease control rate was74.4%（119/160）.The median survival time of no progress was 9.8 months,the median survival time was 14.5 months,1year survival rate was 55%.Multivariate Logistic regression analysis showed,pathological type,skin rash and changes of serum CEA associated with the effective rate（P〈0.05）;pathological type,smoking history,skin rash,changes of serum CEA were correlated with disease control rate（P〈0.05）;pathological types were independent factors affecting the progression free survival,PS was an independent prognostic factors for survival.The first-line and second-line treatment efficacy were similar.Adverse drug reactions including rash and mild diarrhea.Conclusion It demonstrated that the ECFR-TKI is safety and effective in treatment of advanced NSCLC.