CAJ | 학술논문

目的：回顾性比较分析表皮生长因子受体-酪氨酸激酶抑制剂( EGFR-TKIs)、化疗和随访观察等不同干预方案对Ⅰ~Ⅲ期非小细胞肺癌( NSCLC)患者肺癌根治术后1年无瘤生存的影响。了解表皮生长因子受体( EGFR)突变阳性NSCLC患者术后靶向药物治疗的临床价值。方法入组Ⅰ~Ⅲ期行肺癌根治术并且EGFR突变结果明确的NSCLC患者48例,根据突变情况及术后治疗情况分为4组( EGFR突变阳性化疗组、 EGFR突变阴性化疗组、 EGFR突变阳性靶向组、术后随访观察组),以了解不同突变情况及术后不同干预方案下患者1年无瘤生存率的差异。结果肿瘤分期不同是影响1年无瘤生存率的因素, EGFR突变阳性化疗组与突变阳性靶向组1年无瘤生存率为78.6%(11/14) VS 75%(6/8), P=0.620。突变阳性化疗组与突变阴性化疗组1年无瘤生存率为78.6%(11/14) VS 50%(10/20), P=0.153。Ⅲ期患者中, EGFR突变阳性化疗者与EGFR突变阴性化疗者1年无瘤生存率为100%(5/5) VS 18.2%(2/11), P=0.005。对Ⅰ期患者,治疗组与随访观察组1年无瘤生存率为77.8%(7/9) VS 100%(5/5), P=0.505。对Ⅰ期患者,术后随访观察与化疗及靶向治疗比较,1年无瘤生存率无统计学差异。结论对Ⅰ~Ⅲ期接受肺癌根治术后的NSCLC术后患者,分期是影响1年无瘤生存率的因素。对EGFR突变阳性患者,术后化疗与靶向治疗未见1年无瘤生存率差异。对Ⅲ期NSCLC术后患者, EGFR突变阳性患者化疗较突变阴性患者化疗可能有更好的1年无瘤生存率。
목적：회고성비교분석표피생장인자수체-락안산격매억제제( EGFR-TKIs)、화료화수방관찰등불동간예방안대Ⅰ~Ⅲ기비소세포폐암( NSCLC)환자폐암근치술후1년무류생존적영향。료해표피생장인자수체( EGFR)돌변양성NSCLC환자술후파향약물치료적림상개치。방법입조Ⅰ~Ⅲ기행폐암근치술병차EGFR돌변결과명학적NSCLC환자48례,근거돌변정황급술후치료정황분위4조( EGFR돌변양성화료조、 EGFR돌변음성화료조、 EGFR돌변양성파향조、술후수방관찰조),이료해불동돌변정황급술후불동간예방안하환자1년무류생존솔적차이。결과종류분기불동시영향1년무류생존솔적인소, EGFR돌변양성화료조여돌변양성파향조1년무류생존솔위78.6%(11/14) VS 75%(6/8), P=0.620。돌변양성화료조여돌변음성화료조1년무류생존솔위78.6%(11/14) VS 50%(10/20), P=0.153。Ⅲ기환자중, EGFR돌변양성화료자여EGFR돌변음성화료자1년무류생존솔위100%(5/5) VS 18.2%(2/11), P=0.005。대Ⅰ기환자,치료조여수방관찰조1년무류생존솔위77.8%(7/9) VS 100%(5/5), P=0.505。대Ⅰ기환자,술후수방관찰여화료급파향치료비교,1년무류생존솔무통계학차이。결론대Ⅰ~Ⅲ기접수폐암근치술후적NSCLC술후환자,분기시영향1년무류생존솔적인소。대EGFR돌변양성환자,술후화료여파향치료미견1년무류생존솔차이。대Ⅲ기NSCLC술후환자, EGFR돌변양성환자화료교돌변음성환자화료가능유경호적1년무류생존솔。
Objective To compare and analyze how the 1 year disease-free survival rate of the patients with non-small cell lung cancer in stageⅠ~Ⅲafter operation is influenced by the treatment of adjuvant chemotherapy, EGFR-TKIs and only surgery retrospec-tively and to know about the clinical value of EGFR-TKIs therapy on mutated NSCLC patients. Methods 48 NSCLC patients in stageⅠ~Ⅲ who received complete resection and showed clear EGFR mutation result were divided into 4 groups: EGFR mutated patients who received postoperative adjuvant chemotherapy, EGFR mutated-negative patients who received postoperative adjuvant chemothera-py, EGFR mutated patients who took EGFR-TKIs and the patients who had only surgeries. Then, the 1 year disease-free survival rate was observed in each group respectively. Results Only stage affected 1 year disease-free survival rate. For the mutant patients, chemotherapy and EGFR-TKIs therapy showed no statistical difference in 1 year disease-free survival rate : 78. 6% ( 11/14 ) VS 75% (6/8), P=0. 620. For the patients who received adjuvant chemotherapy, mutant and mutant negative patients showed no statis-tical difference:78. 6% (11/14) VS 50% (10/20), P=0. 153, but subgroup analysis for the stage Ⅲ patients, mutant positive and negative showed difference:100% (5/5) VS 18. 2% (2/11), P=0. 005. For the stageⅠpatients, adjuvant therapy and sur-gery only group showed no difference:77. 8% (7/9) VS 100% (5/5), P=0. 505. For the stageⅠpatients taking adjuvant thera-py ( targeted therapy or chemotherapy) showed no statistical difference in 1 year disease-free survival rate. Conclusion For the pa-tients in stage Ⅰ~Ⅲwith complete resection, stage is relative to 1 year disease-free survival rate. For EGFR mutant patients, chem- <br> otherapy and EGFR-TKIs therapy show no statistical difference in 1 year disease-free survival rate. For the mutant positive patients, adjuvant chemotherapy and targeted therapy show no statistical difference in the rate, but for stage Ⅲ patients who received adjuvant chemotherapy, 1-year DFS rate in the mutant positive group may be higher than that in the mutant negative group.