EGFR-TKIs辅助治疗非小细胞肺癌的临床观察

目的：探讨非小细胞肺癌患者EGFR-TKIs辅助治疗的临床疗效及安全性。方法选取127例非小细胞肺癌患者，给予EGFR-TKIs辅助化疗4周后，依据RECIST 1．1标准评价短期临床治疗效果，疾病控制较好患者继续进行EGFR-TKIs辅助化疗，并依据RECIST 1．1标准评价长期临床治疗效果；WHO标准评价不良反应；Kaplan-Meier方法分析EGFR-TKIs辅助治疗非小细胞肺癌后2年生存率。结果 EGFR-TKIs辅助治疗非小细胞肺癌4周后32．28％患者达到病理部分缓解，51．97％患者病情稳定，治疗有效率为32．28％，疾病控制率为84．25％；EGFR-TKIs辅助治疗非小细胞肺癌长期治疗后40．94％患者达到病理部分缓解，14．96％患者病情稳定，治疗有效率为40．94％，疾病控制率为55．91％。皮疹、转氨酶升高、腹泻、胃肠道刺激等是EGFR-TKIs辅助治疗非小细胞肺癌的不良反应，患者Ⅲ～Ⅳ级不良反应发生率较低（主要是皮疹）；患者2年总回访率为96．06％，中位无进展生存期5．3个月，辅助化疗后2年生存率为2．36％。结论 EGFR基因突变型非小细胞肺癌患者接受EGFR-TKIs辅助化疗，临床治疗效果较好且患者耐受性较好。但是治疗后期EGFR-TKIs耐药是影响非小细胞肺癌患者生存率的重要因素。

Clinical Observation of EGFR-TKIs for Patients with Non-small Cell Lung Cancer

Objective To explore the clinical efficacy and safety of EGFR-TKIs for patients with non-small cell lung cancer .Methods 127 patients with non-small cell lung cancer were selected .All of them were given at least 4 weeks of EGFR-TKIs treatment.The short-term therapeutic effects were analyzed by RECIST 1.1 criterion and patients with good disease control were given continued EGFR-TKIs treatment.The long-term therapeutic effects were also analyzed by RECIST 1.1 criterion and side effects was analyzed by WHO standard .Kaplan-Meier method was used to analyze 2-year survival rates after EGFR-TKIs treatment.Results 32.28%non-small cell lung cancer patients had achieved pathological partial response and 51.97%patients had achieved stable disease response after 4 weeks treatment of EGFR-TKIs.The short-term treatment effective rate was 32.28%and the disease control rate was 84.25%.In the long run,40.94%non-small cell lung cancer patients had achieved pathological partial response,14.96%patients had achieved stable disease response ,the short-term treatment effective rate was 40.94% and the disease control rate was 55.91%.The adverse reactions were erythra,aminotransferase elevation,diarrhea,gastrointestinal stimulation and so on .But ⅢtoⅣlevels of adverse reactions in patients were at low incidence ( mainly was erythra ) .The 2-year total return rate after EGFR-TKIs treatment was 96.06%,the median progression-free survival was 5.3 months,and 2-year surviv-al rate of non-small cell lung cancer patients was 2.36%.Conclusion The EGFR-TKIs treatment is effective and well tolerated for non-small cell lung cancer with EGFR gene mutation .But the drug resistance is the main factor affecting survival rate of non-small cell lung cancer .