晚期肺腺癌患者维持治疗中EGFR-TKI联合放疗的回顾性分析

目的 探讨EGFR突变阳性的晚期肺腺癌患者经EGFR-TKI诱导治疗后,以EGFR-TKI联合胸部放疗作为维持治疗的疗效和安全性.方法 收集陆军军医大学西南医院2012年1月至2019年7月收治的EGFR突变阳性、接受一线EGFR-TKI治疗并达到疾病稳定的晚期肺腺癌患者的临床资料,EGFR-TKI诱导治疗达疾病稳定后...

Retrospective study of EGFR-TKI combined with radiotherapy in maintenance therapy for advanced lung adenocarcinoma patients

Objective To investigate the efficacy and safety of EGFR-TKI combined with thoracic radiotherapy as maintenance therapy in patients with advanced lung adenocarcinoma with positive EGFR mutation after induction therapy of EGFR-TKI.Method Collecting the clinical characteristic of patients with advanced lung adenocarcinoma with positive EGFR mutation admitted to southwest Hospital of Army Military Medical University from January 2012 to July 2019,who received first-line EGFR-TKI treatment and achieved disease stability.Patients who underwent EGFR-TKI induction therapy to achieve disease stabilization and then maintained by thoracic radiotherapy were treated as the combined treatment group,maintained with monotherapeutic TKI were treated as the monotherapy group.Progression-free survival(PFS),duration of response(DOR),objective response rate(ORR),disease control rate(DCR)and adverse reactions of two groups were analyzed retrospectively.Results A total of 178 patients met the criteria were collected,including 23 patients in the combined treatment group and 155 patients in the monotherapy group.21 pairs were matched successfully after the propensity score matching at a ratio of 1︰1,Baselines of two groups of patients were consistent(P>0.05).Median PFS was 19.8 months in the combined treatment group and 12.3 months in the monotherapy group(P=0.000).The median DOR was 16.5 months and 9.8 months,respectively(P=0.002).ORR of two group was 85.7%and 76.2%(P=0.687).DOR were 100%in both groups.Grade 3 or worse adverse reactions were 5 cases(23.8%)and 4 cases(19.0%),respectively.The common adverse reactions of the two groups were not significantly different,and the most common was rash,9(42.8%)and 10(47.6%)respectively.In the combined treatment group,there were 11 cases(52.4%)of radioactive pneumonia,including 10 cases of grade 1 and 1 case of grade 2.Conclusion After first-line EGFR-TKI induction therapy,EGFR-TKI combined with thoracic radiotherapy maintenance therapy showed better PFS benefit than EGFR-TKI single-drug maintenance therapy and the combination therapy group had a safety tolerance.