EGFR-TKI耐药后继续应用原TKI联合化疗与单纯化疗疗效比较

目的:研究表皮生长因子受体-酪氨酸酶抑制剂(EGFR-TKI)治疗中晚期肺癌发生耐药后行原TKI联合化疗较单纯化疗有无生存获益。方法:回顾性分析一线化疗联合第一代EGFR-TKI治疗中晚期肺癌发生耐药65例,按照后续治疗方案的不同分为单纯组(单纯培美曲塞化疗)35例和联合组(原TKI联合培美曲塞化疗)30例,比较两组疾病控制率(DCR)、无进展生存期(PFS)及和总生存期(OS)。结果:DCR单纯组51.43%,显著低于联合组的80.00%(P<0.05);中位FPS单纯组6.0个月,显著低于联合组的8.0个月(P<0.05);中位OS单纯组8.0个月,显著低于联合组的10.0个月(P<0.05)。结论:在耐药后使用原TKI联合培美曲塞化疗疗效优于单纯应用培美曲塞化疗,且在Ⅳ期肺癌患者中效果更好,而不良反应可耐受。

Therapeutic effect of original TKI combined with chemotherapy versus chemotherapy alone in advanced lung cancer after EGFR-TKI resistance

Objective: To study the survival benefit of original TKI combined with chemotherapy compared with chemotherapy alone in the treatment of advanced lung cancer after EGFR-TKI resistance. Methods: A retrospective analysis was made on 65 cases of drug resistance in the first-line chemotherapy combined with the first generation EGFR-TKI for advanced lung cancer. According to the different treatment plans,they were divided into simple group( pemetrexed chemotherapy alone,35 cases) and combined group( original TKI combined with pemetrexed chemotherapy,30 cases). The disease control rate( DCR),progression free survival( PFS) and total survival( OS) were compared between the two groups. Results: The DCR of the simple group was51. 43%,significantly lower than 80. 00% of the combined group( P < 0. 05);the median FPS of the simple group was 6. 0 months,significantly lower than 8. 0 months of the combined group( P < 0. 05);the median OS of the simple group was 8. 0 months,significantly lower than 10. 0 months of the combined group( P < 0. 05). Conclusion: The therapeutic effect of original TKI combined with pemetrexed chemotherapy is better than pemetrexed chemotherapy alone for advanced lung cancer after EGFRTKI resistance,especially in patients with stage Ⅳ lung cancer,and the adverse reactions are tolerable.