三种EGFR-TKI药物治疗晚期肺癌疗效及预后因素的回顾性研究

目的:探讨厄洛替尼、吉非替尼、埃克替尼治疗晚期非小细胞肺癌的疗效及安全性。方法:收集从2015年12月至2017年9月被确诊为转移性非小细胞肺癌的46位患者，分析了患者接受三种TKI药物治疗后基线特征、生存期及安全性。结果:研究结果表明，三组患者接受TKI药物治疗后总PFS为9.2个月，厄洛替尼组患者平均PFS为10.8个月，接受吉非替尼及埃克替尼治疗的患者，其PFS分别为7.8 个月和6.7个月。不同EGFR突变类型的肺癌患者，其PFS相似，约9个月。接受TKI治疗前CEA及CYFRA211阳性的患者，其PFS分别为8.0个月和8.5个月。接受TKI治疗前CEA及CYFRA211阴性的患者，其PFS均约为10.8个月。研究中发现，常见的治疗相关不良反应包括乏力、皮疹及腹泻。而肝功能不全、骨髓抑制、浮肿、发热、甲沟炎和疼痛发生率较低。结论:三种TKI药物在具有EGFR敏感突变的晚期转移性肺癌患者中显示了较好的抗肿瘤作用、可耐受药物的毒性。

A retrospective study on the efficacy and prognostic factors of three EGFR-TKI drugs

Objective:To explore the efficacy and safety of erlotinib,gefitinib and icotinib in the treatment of advanced non-small cell lung cancer.Methods:In the retrospective study，46 patients with metastatic non-small cell lung cancer were enrolled in the clinical study from December 2015 to September 2017.The patients characteristics，survival period and efficacy safety were evaluated in our study.Results:The 9.2 months (95%CI 7.0~11.3) of average PFS were seen from the total PFS survival curve.The mean PFS was 10.8 months (95%CI 7.9~13.6) from the data about erlotinib.The patients treated with gefitinib and icotinib had the PFS of 7.8 months(95%CI 2.8~13.9) and 6.7 months (95%CI 1.2~12.1) respectively.The patients with different types of mutations had a similar PFS of 9 months.In the groups of CEA and CYFRA211 positive，the patients had median PFS of 8.0 months (95%CI 5.3~10.7) and 8.5 months (95%CI 6.3~10.7) respectively.In the groups of CEA and CYFRA211 negative，the patients had the same median PFS of 10.8 months.The most common side effects in this clinical study included fatigue，rash，diarrhea.The incidence of liver dysfunction，myelosuppression，edema，fever，paronychia and pain was low.Conclusion:Three TKIs had showed promising clinical effect，mild toxicity and well-tolerated in metastatic non-small cell lung cancer patients with sensitive EGFR mutation.