摘要
目的观察化疗后再次使用表皮生长因子受体—酪氨酸酶抑制剂(EGFR-TKI)治疗晚期获得性EGFR-TKI耐药非小细胞肺癌(NSCLC)患者的临床效果及安全性。方法收集2010年1月—2013年12月辽宁省丹东中心医院诊治晚期获得性EGFR-TKI耐药NSCLC患者79例,采用随机数字表法分为序贯组(先化疗,再采用EGFRTKI治疗)39例和化疗组(单纯给予化疗)40例,对比2组肿瘤标记物、近期疗效、远期疗效及不良反应发生情况。结果序贯组的近期疗效缓解率(20.5%)高于化疗组的(10.0%),但差异无统计学意义(P>0.05);序贵组的总有效率(74.4%)显著高于化疗组(50.0%),差异具有统计学意义(P<0.05)。序贯组的无进展中位生存时间(PFS)为(3.4±0.9)个月,显著长于化疗组的(2.5±0.8)个月(‘=3.981,P<0.05)。序贯组患者总生存时间(OS)为(6.4±1.2)个月,显著长于化疗组的(4.3±1.5)个月,且差异具有统计学意义(t=4.182,P<0.05)。治疗后序贯组的血清癌胚抗原(CEA)、经元特异性烯醇化酶(NSE)、细胞角质蛋白19片段(CYFRA21·1)水平显著低于化疗组(P<0.05)。2组间不良反应发生率及严重程度差异均无统计学意义(P>0.05)。结论化疗后再次使用EGFR-TKI治疗晚期获得性EGFR-TKI耐药NSCLC患者可以延长患者的生存时间且安全可靠。
Objective To observe the therapeutic effect and safety of epidermal growth factor receptor and tyrosinase inhibitor（EGFR-TKI） in the treatment of patients with advanced EGFR-TKI resistance to non small cell lung cancer（NSCLC）.Methods Collected advanced 79 EGFR-TKI resistant NSCLC patients from January 2010 to December 2013 in Liaoning Dandong Central Hospital,they were randomly divided into sequential group（first chemotherapy.then EGFR-TKI treatment） with 39 cases and chemotherapy group（treated with chemotherapy） with 40 cases,compared two groups＇ tumor markers,near future curative effect,long-term efficacy and adverse reactions.Results Short term efficacy response rate（20.5%）in the sequential chemotherapy group（10.0%） was higher than chemotherapy group,but the difference was not statistically significant（P〉0.05）;sequential group overall response rate（74.4%） was significantly higher than that chemotherapy group（50.0%）,the difference was statistically significant（P〈0.05）.Sequential progression-free median survival time（PES） was（3.4±0.9） months,which was significantly longer than chemotherapy group（2.5 ±0.8） months（t =3.981,P〈0.05）.Sequential group＇s overall survival lime（OS） was（6.4 ± 1.2） months,which was significantly longer than chemotherapy group（4.3 ± 1.5） months,and the difference was statistically significant（t =4.182,P〈0.05）.After treatment,serum carcinoembryonic antigen（GEA）,neuron-specific enolase（NSE）,cytokeratin 19 fragment（CYFRA21-1） in sequential group were significantly lower than the chemotherapy group（P〈0.05）.Between the two groups,the incidence of adverse reactions and the severity did not show significant differences（P〉0.05）.Conclusion After chemotherapy,using EGFR-TKI treatment for advanced EGER-TKI resistant NSCLC patients can prolong the survival time of patients and it is safe and reliable.
出处
《疑难病杂志》
CAS
2016年第3期280-283,291,共5页
Chinese Journal of Difficult and Complicated Cases
关键词
表皮生长因子受体-酪氨酸酶抑制剂
耐药
非小细胞肺癌
序贯化疗
Epidermal growth factor receptor and tyrosinase inhibitor
Drug resistance
Non small cell lung cancer
Sequential chemotherapy
