【摘要】 背景与目的表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor tyrosine kinase in-hibitor,EGFR-TKI)治疗非小细胞肺癌(non-small cell lung cancer,NSCLC)有效的临床预测指标包括:女性、亚裔、无吸烟史、腺癌类型以及产生皮疹等,本研究的目的是探寻吉非替尼治疗无进展生存期(progression-free survival,PFS)6个月的NSCLC患者的临床预后因素。方法 2005年1月-2010年3月我组经治80例吉非替尼治疗PFS6个月的NSCLC病例,分析其临床特点与PFS的相关性。结果年龄>70岁、更早的分期(IIIb)、非骨转移患者显示出更长的中位PFS(27个月vs12个月;32个月vs12个月;16个月vs10个月,P<0.05)。ECOG-PS评分0分-1分较2分-3分者、既往化疗周期数多于4周期或化疗PFS长于6个月者较化疗不足4周期或缓解6个月者的吉非替尼中位PFS似乎更长(15个月vs10个月;16个月vs12个月;14个月vs12个月),但差异无统计学意义(P>0.05)。服药后出现皮疹及皮疹II度以上者的中位PFS较无皮疹或皮疹0度-I度者更长(16个月vs13个月,P=0.17;19个月vs11个月,P=0.085),但差异无统计学意义。性别、吸烟指数、病理类型、除骨以外的转移部位、初治或复治等因素与吉非替尼治疗长期获益患者的PFS无关(P>0.05)。结论年龄>70岁、更早的分期(IIIb)岁、非骨转移患者进行吉非替尼治疗可能获得较长的PFS。更多还原

【Abstract】 Background and objective Some clinical predictors can be used to evaluate the efficacy of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) therapy for non-small cell lung cancer (NSCLC),including female,East-Asian,non-smoker,adenocarcinoma,skin rash,etc.The aim of this study is to explore the prognosis of advanced NSCLC patients treated with gefitinib for more than 6 months.Methods Eighty advanced NSCLC patients treated with gefitinib for more than 6 months were collected from January,2005 to March,2010.The association of their clinical characteristics with median progression-free survival time (PFS) was analysed.Results Significantly longer median PFS were found in patients with >70 years old,earlier clinical stage (IIIb),non-bone metastasis (27 months vs 12 months;32 months vs 12 months;16 months vs 10 months,P<0.05).There was no significant difference in median PFS between ECOG performance status 0-1 group and 2-4 group,between more than 4 cycles of chemotherapy and 1-4 cycles,between PFS of chemotherapy >6 months group and ≤6 months group,however,ECOG 0-1 group and more than 4 cycles of chemotherapy or PFS of chemotherapy >6 months group seemed to have longer median PFS (15 months vs 10 months;16 months vs 12 months;14months vs 12 months).Compared with no skin rash and grade 0-I rash group,the patients with rash or grade ≥II rash had longer median PFS (16 months vs 13 months,P=0.171;19 months vs 11 months,P=0.085).The median PFS was not related with sex,smoking index,pathological types,metastatic sites except bone,treatment strategy,etc (P>0.05).Conclusion For gefitinib treatment,longer median PFS is likely to be obtained in patients with >70 years old,earlier clinical stage (IIIb),non-bone metastasis.更多还原