| 手术治疗T790M基因突变阳性肺腺癌并四肢长骨骨转移患者的临床疗效 |
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| 引用本文： | 苏宁,陈珑,王琳,何冬雷,王翠英,冯军. 手术治疗T790M基因突变阳性肺腺癌并四肢长骨骨转移患者的临床疗效[J]. 中国癌症防治杂志, 2019, 11(5): 398-402. DOI: 10.3969/j.issn.1674-5671.2019.05.07 |
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| 作者姓名： | 苏宁 陈珑 王琳 何冬雷 王翠英 冯军 |
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| 作者单位： | 海南省东方市东方医院外科；海南省第三人民医院肿瘤内科 |
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| 基金项目： | 海南省卫生计生行业科研项目（18A200125） |
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| 摘 要： | 目的 比较手术和非手术治疗肺腺癌并四肢长骨转移T790M基因突变阳性患者的临床疗效。方法 选择 2016年7月—2018年12月在海南省东方市东方医院、海南省第三人民医院、海南省人民医院以及海南医学院第一附属医院就诊的肺腺癌并四肢长骨转移T790M基因突变阳性患者36例。根据治疗方式分为手术组（n=17）和非手术组（n=19），手术组行肿瘤切除+肢体功能重建术，非手术组行微创（含介入）治疗或放疗，比较两组患者的临床疗效。结果 手术组视觉模拟疼痛评分法（visual analogue scale，VAS）评分下降比例、Ennecking评分增加比例、Kanofsky评分增加比例均高于非手术组（88.2% vs 52.6%，χ2=5.360，P=0.021；82.4% vs 47.4%， χ2=4.760，P=0.029； 70.6% vs 36.8%，χ2=4.100，P=0.043）；手术组和非手术组有效率和疾病控制率差异无统计学意义（52.9% vs 47.4%，χ2=0.111，P=0.738；76.5% vs 78.9%，χ2=0.032，P=0.858）；生存分析结果显示，手术组中位生存期高于非手术组（12.0个月vs 9.0个月，χ2=5.009，P=0.024）。结论 手术治疗可缓解T790M基因突变阳性肺腺癌并四肢长骨转移患者的疼痛，改善肢体功能，延长生存期。
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Surgical treament for T790M-positive lung adenocarcinoma patients with long bone metastases of extremities |
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| SU Ning,CHEN Long,Wang Lin,HE Donglei,WANG Cuiying,FENG Jun. Surgical treament for T790M-positive lung adenocarcinoma patients with long bone metastases of extremities[J]. Journal of Chinese Medical Abstracts·Oncology, 2019, 11(5): 398-402. DOI: 10.3969/j.issn.1674-5671.2019.05.07 |
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| Authors: | SU Ning CHEN Long Wang Lin HE Donglei WANG Cuiying FENG Jun |
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| Abstract: | Objective To study and compare the clinical application between surgical treatment and non-surgical treatment in T790M-positive lung adenocarcinoma patients with long bone metastases in extremities. Methods Thirty-six patients with T790M-positive lung adenocarcinoma with long bone metastases who were admitted to Dongfang Hospital of Dongfang City，the Third People's Hospital of Hainan Province，Hainan General Hospital and the First Affiliated Hospital of Hainan Medical College from July 2016 to December 2018 were enrolled. They were divided into the surgical treatment group（n=17） and the non-surgical treatment group（n=19） based on treatment methods. The patients in the surgical treatment group underwent tumor resection and limb functional reconstruction，The non-surgical treatment group received minimally invasive treatment（including interventional therapy） or radiotherapy. The clinical efficacy was compared between the two groups. Results The visual analogue scale（VAS） score reduction rates，the Ennecking score increasing rates，the Kanofsky score increasing rates of patients in surgical treatment group were higher than those in non-surgical treatment group respectively（88.2% vs 52.6%，χ2=5.360，P=0.021；82.4% vs 47.4%，χ2=4.760，P=0.029；70.6% vs 36.8%，χ2=4.100，P=0.043）. There was no significant difference in the response rate and the disease control rate of both groups after treatment（52.9% vs 47.4%，χ2=0.111，P=0.738；76.5% vs 78.9%，χ2=0.032，P=0.858）. The median survival of patients of the surgical treatment group was higher than non-surgical treatment group，the differences was statistically significant （12.0 months vs 9.0 months，χ2=5.009，P=0.024）. Conclusion Surgical treatment can significantly reduce pain，improve limb function and the median survival of T790M-positive lung adenocarcinoma patients with long bone metastases in extremities. |
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| Keywords: | Lung adenocarcinoma Osimertinib T790M Bone metastasis Surgical treatment |
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