EGFR基因突变对靶向治疗非小细胞肺癌患者的疗效影响及生存分析

目的 探讨表皮生长因子受体(EGFR)基因不同染色体上外显子突变对靶向治疗非小细胞肺癌患者的疗效影响及生存分析.方法 选取76例EGFR基因敏感突变非小细胞肺癌患者,根据EGFR基因检测结果分为四组:A组,EGFR基因18号染色体上外显子突变型组(18例);B组,EGFR基因19号染色体上外显子突变型组(20例);C组,EGFR基因20号染色体上外显子突变型组(19例);D组,EGFR基因21号染色体上外显子突变型组(19例).同时选取同期住院治疗的20例EGFR基因野生型(EGFR基因未突变)非小细胞肺癌患者作为E组(对照组).各组患者均给予吉非替尼(250 mg/d)治疗.结果 与E组比较,A、B、D组的总有效率和疾病控制率均升高,差异均有统计学意义(P均<0.05);与E组比较,C组的总有效率和疾病控制率均降低,差异均有统计学意义(P均<0.05).与E组比较,A、B、D组PFS、OS和QOL均升高,差异均有统计学意义(P均<0.05);与E组比较,C组的PFS、OS和QOL均降低,差异均有统计学意义(P均<0.05).与E组比较,A、B、D组总不良反应发生率均降低,差异均有统计学意义(P均<0.05);与E组比较,C组的总不良反应发生率升高,差异有统计学意义(P<0.05).结论 采用靶向药物吉非替尼治疗EGFR基因18、19和21号染色体上外显子突变的非小细胞肺癌患者效果较好,同时延长患者生存时间,降低不良反应;相反,采用靶向药物吉非替尼治疗EGFR基因20号染色体上外显子突变的非小细胞肺癌患者因出现耐药而效果不佳.

Effect of EGFR Mutations on Targeted Therapy in the Treatment of Patients with Non-small Cell Lung Cancer and Prognosis Analysis

Objective To investigate the effect of EGFR mutations on targeted therapy in the treatment of patients with non-small cell lung cancer and prognosis analysis .Methods 76 cases patients with non-small cell lung cancer and EGFR mutationwere analyzed,and divided into four groups.A group (18 cases):patients with non-small cell lung cancer and EGFR mutationin exon 18.B group (20 cases):patients with non-small cell lung cancer and EGFR mutation in exon 19.C group (19 cases):patientswith non-small cell lung cancer and EGFR mutation in exon 20.D group (19 cases):patients with non-small cell lung cancerand EGFR mutation in exon 21.All patients were treated with gefitinib (250 mg/d).After treatment,clinical efficacy,survivaland toxicity were compared in all groups.Results Compared with E group,the total effective rate and the disease control rate inA,B and D groups were all higher (Pall <0.05).Compared with E group,the total effective rate and the disease control rate in Cgroup were all lower (Pall <0.05).Compared with E group,the levels of PFS,OS and QOL in A,B and D groups were all higher(Pall <0.05).Compared with E group,the levels of PFS,OS and QOL in C group were all lower (Pall <0.05).Compared withE group,the levels of adverse reactions in A,B and D groups were all lower (Pall <0.05).Compared with E group,the level ofadverse reactions in C group was higher (Pall <0.05).Conclusion Targeted therapy in the treatment of patients with non -smallcell lung cancer with EGFR mutation in exon 18,19,21 can effectively improve the clinical symptoms and prognosis ,reduce therate of adverse reactions.On the contrary,targeted therapy in the treatment of patients with non -small cell lung cancer with EGFRmutation in exon 20 can effectively reduce the clinical symptoms and prognosis ,reduce the rate of adverse reactions.