晚期非小细胞肺癌患者使用EGFR-TKI治疗后长期生存情况的研究

【作者】 管慧；

【导师】 李龙芸；

【作者基本信息】 北京协和医学院 ， 临床医学， 2010， 博士

【摘要】 目的探索用常见的表皮生长因子受体酪氨酸激酶抑制剂治疗晚期非小细胞肺癌(NSCLC)患者,影响长期生存情况的因素,研究长期生存者血清EGFR突变情况。方法回顾性分析从2002年12月——2007年6月在北京协和医院进行EGFR-TKI治疗的292例晚期非小细胞肺癌患者,收集所有长期生存(定义为使用吉非替尼或厄洛替尼治疗后存活时间大于3年)患者的相关临床资料(年龄组、性别、组织学、吸烟史、疾病分期、未接受过治疗或已接受过治疗、治疗反应等)进行比较,对其中仍存活的患者进行血清EGFR检测,收集存活患者中已检测过的EGFR突变数据。结果EGFR-TKI治疗晚期NSCLC3年生存率16.1%。吸烟史(P=0.033)和病理类型(P=0.006)是与EGFR-TKI治疗生存时间密切相关的因素,而性别(P=0.311)、年龄(P=0.121)、ECOG评分(P=0.299)及临床分期(P=0.235)则与之无显著关系。长期存活患者EGFR敏感突变率65.2%,女性(68.8%)和腺癌(71.4%)突变率最高。结论EGFR-TKI是有效的治疗NSCLC的靶向药物,可以改善NSCLC患者的生存时间。根据患者具体情况选择合适肺癌患者并进行吉非替尼治疗可望使肺癌治疗更为个体化,具有更好的临床应用前景。EGFR敏感突变可能能用来预测患者预后。更多还原

【Abstract】 ObjectiveTo investigate the factors that influence the long-term survival of patients with advanced non-small cell lung cancer(NSCLC) who were treated with epidermal growth factor receptor(EGFR)-tyrosine kinase inhibitor. And detect the EGFR mutations of these long-term survival patients.MethodsFrom December2002to June2007,292patients with advanced NSCLC were enrolled for treatment with EGFR-TKI in Peking Union Medical College Hospital. Clinical data was analyzed by Pearson’s Chi-square test. Detect the EGFR mutations of the living patients in the serum samples by DNA sequencing method.ResultsThe long-term survival of EGFR-TKI-treated patients had a3-year survival rate of16.1%, which was correlated with smoking history (P=0.033), and pathological type(P=0.006). It was not correlated with gender(P=0.311), age(P=0.121), ECOG score(P=0.299), and clinical stage(P=0.235). EGFR sensitive mutation rate in the serum of long-term survival patients was65.2%, and the mutation rates of female patients (68.8%) and adenocarcinoma patients were higher than the others.ConclusionsEGFR-TKI offers a new treatment option for advanced NSCLC. EGFR mutation status may have important significance for evaluating the prognosis of advance NSCLC patients treated with EGFR-TKI.更多还原