一线靶向治疗对于Ⅰ期EGFR基因突变的非小细胞肺癌术后肺内复发患者的临床疗效

发布时间：2018-01-20 01:49

本文关键词： 肺癌表皮生长因子受体酪氨酸激酶抑制剂术后复发 Ⅰ期疗效　出处：《浙江大学》2017年硕士论文　论文类型：学位论文

【摘要】：背景:表皮生长因子受体酪氨酸激酶抑制别(epidermal growth factor receptor tyrosine kinase inhibitor,EGFR-TKIs)目前广泛应用于携带EGFR基因突变的晚期非小细胞肺癌患者,多项临床研究表明其能够有效延长患者的无进展生存期以及提高其生活质量。然而,对于EGFR-TKIs治疗I期非小细胞肺癌术后肺内复发的患者,目前还没有特定的相关报道给出具体疗效评价。方法:选取22例在浙江大学附属第二医院胸外科行完全性切除术后出现肺内复发并接受一线靶向治疗的Ⅰ期肺腺癌患者,对其临床资料进行回顾性分析。结果:22例患者皆可评价疗效,17例获得了部分缓解,5例获得了疾病稳定,其客观缓解率为77.3%,疾病控制率为100%,中位无进展生存期为16.5月。研究发现肺内复发伴转移的患者较仅肺内复发的患者无进展生存期更短(10月vs 17月,p=0.017)。年龄≥65与65岁、男性与女性、有吸烟史与无吸烟史、EGFR 21基因突变与EGFR19基因突变、服用吉非替尼与服用埃克替尼、不同T分期和不同肺叶切除的患者的无进展生存期无明显统计学差别。结论:我们的研究显示一线靶向治疗对于EGFR基因突变Ⅰ期非小细胞肺癌术后肺内复发的患者有着较好的疗效,可以作为该类患者的一项治疗策略选择。
[Abstract]:Background: epidermal growth factor receptor tyrosine kinase inhibitor (epidermal growth factor receptor tyrosine't kinase inhibitor, EGFR-TKIs) is widely used in carrying EGFR gene mutation in patients with advanced non-small cell lung cancer, a number of clinical studies show that it can effectively delay the progression free survival long patients and improve their quality of life. However, for the treatment of I EGFR-TKIs non small cell lung cancer patients with pulmonary recurrence after operation, there is no relevant reports given specific efficacy evaluation. Methods: 22 cases in the Second Affiliated Hospital of Zhejiang University Department of thoracic surgery after complete resection for intrapulmonary recurrence and received first-line targeted therapy in patients with stage I lung adenocarcinoma, and the clinical data were reviewed analysis. Results: 22 patients were evaluable for efficacy, 17 cases achieved partial remission, 5 patients achieved stable disease, the objective response rate was 77. 3%, the disease control rate was 100%, median progression free survival was 16.5 months. The study found that patients with metastatic lung recurrence compared with intrapulmonary recurrence in patients with shorter progression free survival (October vs 17 months, p=0.017). Aged 65 and 65 years old, male and female, with a history of smoking and no smoking history 21, EGFR gene mutation and EGFR19 gene mutation, received gefitinib and taking icotinib, different T stages and different lobectomy in patients with progression free survival was no significant difference. Conclusion: our study showed that first-line targeted therapy for EGFR gene mutation in stage I non-small cell lung cancer patients after pulmonary recurrence the patient has a good curative effect, can be used as a treatment strategy for the patients.

【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R734.2

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