EGFR-TKIs联合化疗一线治疗晚期EGFR基因突变非小细胞肺癌患者的疗效观察

目的:分析比较表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs)联合化疗与EGFR-TKIs单药一线治疗晚期非小细胞肺癌(NSCLC)的疗效和安全性。方法:回顾性分析2010年09月至2015年12月晚期EGFR突变阳性NSCLC患者100例,根据治疗方案分为联合组(50例)和单药组(50例),联合组采用EGFR-TKIs联合化疗治疗,单药组采用EGFR-TKIs单药治疗。比较两组患者的治疗效果、预后情况以及毒副作用。结果:联合组总有效率为66%(33/50),单药组为48%(24/50),组间比较差异无统计学意义(P=0.106);联合组的疾病控制率为88%(44/50),单药组的疾病控制率为68%(34/50),组间比较差异有统计学意义(P=0.028)。联合组和单药组的中位PFS分别为18.5个月和13.5个月,差异有统计学意义(P=0.013),两组的OS分别为36个月和28.5个月,差异无统计学意义(P=0.071)。单药组和联合组的3-4级治疗相关不良反应发生率分别为6%和10%,差异无统计学意义(P=0.463)。结论:与EGFR-TKIs单药相比,EGFR-TKIs联合化疗一线治疗晚期EGFR基因突变NSCLC患者,可提高PFS,且不良反应可耐受。

Efficacy of EGFR-TKIs combined with chemotherapy in the first-line treatment of advanced non-small cell lung cancer with EGFR gene mutation

Objective:To compare efficacy and safety of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKIs) combined with chemotherapy versus single EGFR-TKIs for advanced non-small cell lung cancer (NSCLC).Methods:100 NSCLC patients with EGFR gene mutation were retrospective analyzed from September 2010 to December 2015,and divided into the combination group (n=50) and single group (n=50).The combination group was treated with EGFR-TKIs combined with chemotherapy,and the single group was treated with EGFR-TKIs.After treatment,clinical efficacy,survival and toxicity were compared in the 2 groups.Results:The total effective rate in the combination group was 66%（33/50） and the total effective rate in the signal group was 48%（24/50）.There were no significant differences in the total effective rate between the 2 groups (P=0.106).The disease control rate in the combination group was 88%（44/50） and the disease control rate in the signal group was 68%（34/50）.There were significant differences in the disease control rate between the 2 groups (P=0.028).The median progression-free survival (PFS) was significantly longer in combination group than in single group (18.5 months vs 13.5 months,P=0.013).Overall survival (OS) was no significant between the two groups (36 months vs 28.5 months,P=0.071).The incidence of sever adverse events (grade 3-4) were less common with single group (6%) than combination group (10%) (P=0.463).Conclusion:Compared with EGFR-TKIs single,the combination of EGFR-TKIs and chemotherapy can prolong the PFS compared with EGFR-TKIs alone for the first-line treatment of NSCLC with EGFR mutation-positive,and the adverse reactions were tolerable.