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中国癌症防治杂志

中国癌症防治杂志 ›› 2015, Vol. 7 ›› Issue (2): 94-99.doi: 10.3969/j.issn.1674-5671.2015.02.06

• 临床研究 • 上一篇    下一篇

多西他赛或表皮生长因子受体酪氨酸激酶抑制剂二线治疗晚期非小细胞肺癌的临床观察

  

  1. 广西医科大学附属肿瘤医院化疗二科；广西医科大学研究生学院；昆明市延安医院
  • 出版日期:2015-04-25 发布日期:2015-05-14
  • 通讯作者: 周韶璋
  • 基金资助:

    国家自然科学基金资助项目（81260357；81060188）

Docetaxel versus EGFR-TKIs as second-line treatment in patients with advanced non-small cell lung cancer

  • Online:2015-04-25 Published:2015-05-14
  • Contact: 179913337@qq.com

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被引次数

6

摘要：

目的 观察多西他赛或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）二线治疗晚期非小细胞肺癌（non-small cell lung cancer，NSCLC）的临床疗效及安全性。 方法 回顾性分析2009年1月至2013年6月接受多西他赛或EGFR-TKIs二线治疗晚期NSCLC患者的临床资料，对符合入组标准的100例进行观察和分析，其中52例接受EGFR-TKIs治疗（TKIs组），48例接受多西他赛治疗（DOC组）。采用Kaplan-Meier方法计算两组患者的中位无疾病进展生存时间（mPFS） 、中位总生存时间（mOS），并行Log-rank检验。结果 TKIs组、DOC组患者二线治疗后mPFS分别为6个月、3个月（P=0.021）；mOS分别为16个月、10个月（P=0.068）；客观有效率（ORR）分别为23.1％、6.3％（P=0.038）。DOC组Ⅲ~Ⅳ级白细胞减少、中性粒细胞减少及其引起发热的发生率明显高于TKIs组（P均＜0.001）。结论 临床上对具有EGFR敏感突变潜在临床特征的晚期NSCLC患者进行二线治疗时，EGFR-TKIs比多西他赛治疗能显著延长患者中位无疾病进展生存时间，毒副反应较少，具有更高的安全性。

关键词: 肺肿瘤, 化疗, 多西他赛, 表皮生长因子受体酪氨酸激酶抑制剂, 二线治疗, 疗效

Abstract:

Objective To compare the efficacy and safety of docetaxel versus epidermal growth factor receptor tyrosine kinase inhibitors （EFGR-TKIs） in the second-line treatment of patients with advanced non-small cell lung cancer （NSCLC）. Methods Clinical data were retrospectively analyzed for 100 patients with advanced NSCLC who received second-line therapy at Affiliated Tumor Hospital of Guangxi Medical University from January 2009 to June 2013. Among the patients，52 were treated with EGFR-TKIs and 48 with docetaxel. Median progression-free survival（PFS） and median overall survival（OS） were estimated by the Kaplan-Meier method and compared using the log-rank test. Results Median PFS was 6 months in the EGFR-TKI group and 3 months in the docetaxel group（P=0.021）. Median OS was 16 months in the EGFR-TKI group and 10 months in the docetaxel group（P=0.068）. The ORR was 23.1% in the EGFR-TKI group and 6.3% in the docetaxel group（P=0.038）. Patients in the docetaxel group showed significantly higher rates of grade 3 to 4 leukopenia，neutropenia and febrile neutropenia（all P＜0.001）. Conclusion EGFR-TKIs show significantly better median PFS and a favorable safety profile compared with docetaxel in the second-line treatment of patients with advanced NSCLC at high risk of EGFR mutations.

Key words: Lung neoplasm, Chemotherapy, Docetaxel, Epidermal growth factor receptor tyrosine kinase inhibitors, Second-line therapy, Efficacy