摘要
目的探讨晚期非小细胞肺癌（NSCLC）表皮生长因子受体-酪氨酸激酶抑制剂（EGFR-TKI）获得性耐药患者化疗后序贯应用EGFR-TKI的疗效和不良反应。
方法回顾性分析2013年1月至2016年12月96例晚期NSCLC EGFR-TKI获得性耐药患者的临床资料，表皮生长因子（EGFR）均突变阳性，其中51例给予单纯化疗（对照组），45例化疗后序贯应用EGFR-TKI（观察组）。对两组客观缓解率、疾病控制率以及不良反应情况进行统计分析。结果与对照组比较，观察组的客观缓解率明显升高[24.4%（11/45）比11.8%（6/51），P=0.037]，疾病控制率亦明显升高[77.8%（35/45）比52.9%（27/51），P=0.023]，无进展生存期明显延长[（7.4 ± 2.0）个月比（4.5 ± 1.2）个月，P=0.029]，不良反应中皮疹发生率明显增加[35.6%（16/45）比7.8%（4/51），P=0.008]，而其他不良反应两组比较差异均无统计学意义（P〉0.05）。结论针对晚期NSCLC EGFR-TKI获得性耐药患者在化疗后序贯应用EGFR-TKI较给予单纯化疗能获得更好疗效，同时不良反应相似，患者均可耐受。
ObjectiveTo explore the therapeutic efficacy and safety of chemotherapy sequential epidermal growth factor receptor-tyrosine kinase inhibitor （EGFR-TKI） for advanced non-small cell lung cancer （NSCLC） patients with EGFR-TKI acquired resistance.MethodsThe clinical features of 96 advanced NSCLC patients with EGFR mutation positive and EGFR-TKI acquired resistance from January 2013 to December 2016 were retrospectively reviewed. Forty-five patients who received chemotherapy sequential EGFR-TKI were enrolled in observation group, and another fifty-one who accepted chemotherapy alone were enrolled in control group. The objective response rates, disease control rates and adverse effects were compared between two groups.ResultsCompared with that of the control group, the objective response rate of the observation group was significantly higher [24.4% （11/45） vs.11.8% （6/51）, P=0.037], the disease control rate was also significantly increased [77.8% （35/45） vs.52.9% （27/51）, P=0.023], the progression free survival was obviously prolonged [（7.4 ± 2.0） months vs.（4.5 ± 1.2） months, P=0.029], the incidence of rash in adverse reactions was significantly increased [35.6% （16/45） vs. 7.8%（4/51）, P=0.008]. There were no significant difference in the side effects between the two groups （P 〉 0.05）.ConclusionsCompared with chemotherapy alone, chemotherapy combined with sequential EGFR-TKI could bring better clinical efficacy for NSCLC patients with EGFR-TKI acquired resistance, and the adverse effects could be tolerated.
作者
季艳霞
康振桥
陈永革
张晓光
李静
Ji Yanxia;Kang Zhenqiao;Chen Yongge;Zhang Xiaoguang;Li Jing(Department of Oncology,Handan Central Hospital,Hebei Handan 056001,China)
出处
《中国医师进修杂志》
2018年第8期731-734,共4页
Chinese Journal of Postgraduates of Medicine
关键词
癌
非小细胞肺
受体
表皮生长因子
抗药性
肿瘤
抗肿瘤联合化疗方案
Carcinoma
non-small-cell lung
Receptor
epidermal growth factor
Drugresistance
neoplasm
Antineoplastic combined chemotherapy protocols
作者简介
通信作者：季艳霞，Email：xjm9571@163．com
