EGFR-TKIs治疗术后复发肺腺鳞癌患者的临床研究

发布时间：2018-08-27 09:36

【摘要】：目的:分析表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor tyrosine kinase inhibitors,EGFR-TKIs)治疗术后肺腺鳞癌(adenosquamous carcinoma of the lung,ASC)患者的疗效。方法:回顾性分析2006年1月至2014年12月上海交通大学附属胸科医院诊治的ASC 205例,采用描述性分析及Kaplan-Meier法进行生存分析。结果:筛选出27例EGFR突变并接受TKIs治疗的ASC患者,其中15例患者存在19号外显子缺失突变,12例患者存在21号外显子点突变。临床疗效方面,9例患者部分缓解(partial response,PR),11例患者疾病稳定(stable disease,SD),疾病控制率(disease control rate,DCR)为74.1%。生存分析结果显示,术后中位生存时间为39.0个月(95%CI:25.6~52.4),中位无进展生存时间为15.0个月(95%CI:12.9~17.1),3、5年生存率分别为51.9%、15.3%。结论:具有EGFR敏感突变的ASC患者能够从TKIs治疗中获益,推荐对ASC患者进行常规EGFR基因突变检测,实现个体化、多学科治疗以改善患者预后。
[Abstract]:Objective: to evaluate the efficacy of epidermal growth factor receptor tyrosine kinase inhibitor (epidermal growth factor receptor tyrosine kinase inhibitors,EGFR-TKIs) in the treatment of postoperative lung adenosquamous carcinoma (adenosquamous carcinoma of the lung,ASC). Methods: from January 2006 to December 2014, 205 cases of ASC diagnosed and treated in affiliated chest Hospital of Shanghai Jiaotong University were analyzed retrospectively. The survival analysis was performed by descriptive analysis and Kaplan-Meier method. Results: 27 ASC patients with EGFR mutation were screened and treated with TKIs. Among them, 15 patients had exon 19 deletion mutation and 12 patients had exon 21 mutation. In terms of clinical efficacy, 9 cases of partial remission (partial response,PR) and 11 cases of disease stability (stable disease,SD), disease control rate (disease control rate,DCR) were 74.1%. Survival analysis showed that the median survival time was 39.0 months (95%CI:25.6~52.4), the median progression-free survival time (95%CI:12.9~17.1) was 15.0 months, and the 5-year survival rate was 51.9 months. Conclusion: ASC patients with EGFR sensitive mutation can benefit from TKIs therapy. Routine detection of EGFR gene mutation in ASC patients is recommended to achieve individualized and multidisciplinary therapy to improve the prognosis of ASC patients.
【作者单位】：上海交通大学附属胸科医院胸外科;湖北省十堰市人民医院胸外科;
【分类号】：R734.2

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