CAJ | 학술논문

目的探讨表皮生长因子受体-酪氨酸激酶抑制剂(EGFR-TKI)治疗晚期非小细胞肺癌(NSCLC)以及肺癌合并脑转移患者的疗效、预后及不良反应.方法回顾性分析2007年1月至2012年8月福建省立医院收治的接受EGFR-TKI治疗的晚期NSCLC患者临床资料,所有患者口服EGFR-TKI直到病变进展或出现不可耐受的不良反应.结果 52例晚期NSCLC患者接受EGFR TKI治疗的客观缓解率(ORR)为34.6％(18/52),疾病控制率(DCR)为75.0％(39/52),中位无进展生存期(PFS)为6.0个月,中位总生存期(MST)为18.0个月.腺癌、不吸烟、服药前肿瘤大小＜5 cm的患者DCR高于非腺癌、吸烟、服药前肿瘤大小≥5 cm者(P＜0.05).生存分析示服药前肿瘤大小＜5 cm、疾病控制者的中位PFS优于服药前肿瘤大小≥5 cm、疾病进展者(P＜0.05).而无吸烟史、服药前肿瘤大小＜5 cm者的MST优于有吸烟史、服药前肿瘤大小≥5 cm者(P＜0.05).21例肺癌合并脑转移患者口服EGFR TKI治疗后颅内病灶的ORR为38.1％,DCR为90.5％;全身病变的ORR为38.1％,DCR为85.7％.本研究中最常见的不良反应为皮疹(25.0％)、皮肤瘙痒(19.2％).结论 EGFR-TKI治疗晚期NSCLC是有效、安全的;EGFR-TKI对脑转移存在一定疗效.
목적 탐토표피생장인자수체-락안산격매억제제(EGFR-TKI)치료만기비소세포폐암(NSCLC)이급폐암합병뇌전이환자적료효、예후급불량반응.방법 회고성분석2007년1월지2012년8월복건성립의원수치적접수EGFR-TKI치료적만기NSCLC환자림상자료,소유환자구복EGFR-TKI직도병변진전혹출현불가내수적불량반응.결과 52례만기NSCLC환자접수EGFR TKI치료적객관완해솔(ORR)위34.6％(18/52),질병공제솔(DCR)위75.0％(39/52),중위무진전생존기(PFS)위6.0개월,중위총생존기(MST)위18.0개월.선암、불흡연、복약전종류대소＜5 cm적환자DCR고우비선암、흡연、복약전종류대소≥5 cm자(P＜0.05).생존분석시복약전종류대소＜5 cm、질병공제자적중위PFS우우복약전종류대소≥5 cm、질병진전자(P＜0.05).이무흡연사、복약전종류대소＜5 cm자적MST우우유흡연사、복약전종류대소≥5 cm자(P＜0.05).21례폐암합병뇌전이환자구복EGFR TKI치료후로내병조적ORR위38.1％,DCR위90.5％;전신병변적ORR위38.1％,DCR위85.7％.본연구중최상견적불량반응위피진(25.0％)、피부소양(19.2％).결론 EGFR-TKI치료만기NSCLC시유효、안전적;EGFR-TKI대뇌전이존재일정료효.
Objective To explore the efficacy,prognosis,and side effects of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy for advanced non-small cell lung cancer and lung cancer with brain metastasis.Methods Clinical datas of advanced non-small cell lung cancer who received EGFR-TKI treatment in Fujian Provincial Hospital from January 2007 to August 2012 were retrospectively analyzed.All patients received EGFR-TKI until the disease progression or intolerable toxicity.Results The objective response rate (ORR) and the disease control rate (DCR) after administration of EGFR-TKI were 34.6％ (18/52) and 75.0％ (39/52),respectively.The median progression free survival time and overall survival time were six months and 18 months,respectively.The DCR in patients with adenocarcinoma,non-smoking,and tumor size ＜5 cm was higher than that in patients with non-adenocarcinoma,smokers and tumor size ≥ 5 cm (P ＜ 0.05).Survival analysis suggested that the median progression survival in patients with tumor size ＜5 cm and stable disease was longer than that in patients with tumor size ≥ 5 cm and progression disease (P ＜ 0.05).The median survival time in non-smokers and patients of tumor size ＜ 5 cm was longer than that in smokers and patients of tumor size ≥5 cm (P ＜0.05).Among 21 cases of lung cancer with brain metastasis treated with EGFR-TKI,overall ORR and DCR of intracranial lesions were 38.1 ％ and 90.5 ％,respectively.The ORR and DCR of systemic disease were 38.1％ and 85.7％,respectively.The most common side effects were rash (25.0 ％) and pruitus (19.2 ％).Conclusions EGFR-TKI is effective and safe in the treatment of advanced non-small cell lung cancer patients.EGFR-TKI may be effective on brain metastases in lung cancer patients.