吉非替尼、厄洛替尼与埃克替尼治疗EGFR基因敏感突变晚期NSCLC患者的疗效观察

目的:观察吉非替尼、厄洛替尼与埃克替尼在EGFR基因敏感突变晚期非小细胞肺癌(NSCLC)患者一线治疗中的疗效差异。方法:收集2013年5月—2014年12月间在我院接受治疗的76例EGFR基因突变的晚期NSCLC患者，随机分为三组，A组接受吉非替尼治疗，250 mg，1次/d，空腹口服;B组接受厄洛替尼治疗，150 mg，1次/d，餐前1 h口服;C组接受埃克替尼治疗，125 mg，3次/d，评价疗效及安全性。结果:吉非替尼组、厄洛替尼组和埃克替尼组的客观有效率（ORR）分别为26.9%、34.6%和45.8%；疾病控制率（DCR）分别为61.5%、73.0%和79.2%。三组之间的有效率和疾病控制率差异无统计学意义(P＞0.05）。三组的无进展生存时间（PFS）分别为9.5个月、10个月和9.5个月；19号外显子缺失突变型患者中，三组的PFS分别为8.5个月、12个月和9个月；21号外显子L858R错义突变型患者中，PFS分别为9.5个月、8.5个月和7个月，三组之间无统计学差异(P＞0.05）。结论:吉非替尼、厄洛替尼与埃克替尼治疗EGFR基因突变的晚期NSCLC疗效相似，但在19号外显子缺失突变型患者中，厄洛替尼略显优势。

Efficacy of gefitinib,erlotinib and icotinib in advanced non-small cell lung cancer(NSCLC) with EGFR mutation

Objective:To compare the efficacy of the gefitinib,erlotinib and icotinib in the first-line treatment of patients with advanced EGFR mutation-positive NSCLC.Methods:Clinical data about 76 patients with advanced non-small cell lung cancer in our hospital from May 2013 to December 2014 were retrospectively analyzed.They were randomly divided into gefitinib group,erlotinib group and icotinib group to evaluate the efficacy and safety.Results:There were no significant differences in the objective response rate and disease control rate of the three groups.The PFS of the three groups was 9.5 months,10 months and 9.5 months,respectively.The efficacy of the three drugs was similar.Conclusion:There is significant differences of gefitinib,erlotinib and icotinib in the patients with advanced EGFR mutation-positive NSCLC.But in patients with 19 exon deletion mutant,there is more advantage for erlotinib.