一代EGFR-TKI联合同步放疗治疗EGFR-TKI耐药晚期肺腺癌患者的有效性和安全性

目的:探索第一代EGFR酪氨酸激酶抑制剂（EGFR-TKI）耐药后继续口服EGFR-TKI并联合局部放疗治疗晚期肺腺癌的有效性和安全性。方法:回顾性纳入2014年1月至2017年7月期间本中心符合纳入标准的、接受第一代EGFR-TKI联合局部放疗治疗的晚期肺腺癌患者，分析其疗效及不良事件发生情况。结果:研究纳入了64例符合纳入标准及排除标准的患者，继续口服原EGFR-TKIs并联合局部放疗的平均PFS为（5.48±3.85）个月。PFS与患者进展病灶不同数量相关，出现1、2、3个病灶进展患者的无进展生存期分别为6.60个月、5.17个月和 2.82个月，组间比较有显著统计学差异（P=0.006）。继续口服原EGFR-TKIs并联合局部放疗总体3-4级不良事件发生率为10.9%。结论:第一代EGFR-TKI联合局部放疗是EGFR-TKI治疗晚期肺腺癌后局部进展的有效治疗方式之一。

Efficacy and safety of continuous EGFR-TKIs administration combined with concurrent radiotherapy in local progressed advanced lung adenocarcinoma patients previously treated with the first EGFR-TKIs

Objective:To investigate the effectiveness and safety of continuous EGFR-TKIs administration combined with concurrent radiotherapy after local progression in advanced lung adenocarcinoma patients previously treated with the first EGFR-TKIs.Methods:EGFR-mutant advanced NSCLC patients in accord with the inclusion criteria who were treated with previous EGFR-TKIs and assessed as local progression were retrospectively included from January 2014 to July 2017.Efficacy and safety information were recorded and analyzed.Results:64 patients in accord with the inclusion criteria and the exclusion criteria were included.Continuous EGFR-TKIs administration combined with concurrent radiotherapy could got a progression-free survival (PFS) of 5.48 months.PFS was significantly associated with the number of progressed lesions (median PFS:1 vs 2 vs 3 progressed lesions=6.60 vs 5.17 vs 2.82 months).There was a statistically significant difference between the groups (P=0.006).The overall 3-4 grade adverse event of this treatment was 10.9%.Conclusion:Continuous EGFR-TKIs administration combined with concurrent radiotherapy after local progression is a efficient treatment in advanced non-small cell lung cancer patients previously treated with the first EGFR-TKIs.