【摘要】 目的观察中医辨证治疗联合埃克替尼对表皮生长因子受体(EGFR)突变老年晚期肺腺癌患者生存期的影响。方法将74例EGFR突变老年晚期肺腺癌患者随机分为治疗组和对照组,每组37例,对照组单用埃克替尼治疗,治疗组在此基础上加用中医辨证汤剂。观察治疗后疾病发生进展及死亡的时间,计算中位疾病无进展生存期(mPFS)及中位生存期(MST)。结果 (1)随访至2020年7月30日,治疗组脱落1例、对照组脱落2例,共纳入71例病例进行统计,其中治疗组36例、对照组35例。(2)治疗组、对照组mPFS分别为15.40个月、13.07个月,组间差异有统计学意义(P=0.024,HR=0.575)。(3)治疗组、对照组的MST分别为29.90个月、25.07个月,组间差异有统计学意义(P=0.045,HR=0.580)。(4)多因素分析结果显示,联合中医药治疗、一线埃克替尼治疗、曾经接受肺癌根治术、较少的合并症是影响EGFR突变老年晚期肺腺癌患者远期生存预后的独立保护因素(P<0.05)。结论中医辨证治疗联合埃克替尼可延长EGFR突变老年晚期肺腺癌患者的无进展生存期及总生存期,一线埃克替尼治疗阶段、肺癌根治术及较少的合并症也有利于老年晚期肺腺癌患者的远期生存预后。更多还原

【Abstract】 Objective To observe the effect of traditional Chinese medicine（TCM） syndrome differentiation and treatment combined with Icotinib on the overall survival of elderly patients with advanced lung adenocarcinoma with epidermal growth factor receptor（EGFR） mutation. Methods A total of 74 elderly patients with EGFR-mutant advanced lung adenocarcinoma were randomly divided into treatment group（n=37） and control group（n=37）. The control group was administered with Icotinib alone, and the treatment group was additionally administered with TCM decoction based on syndrome differentiation besides Icotinib. The time of disease progression and death after treatment in the two groups was observed, and the median progression-free survival（mPFS） time and median survival（MST） time were calculated. Results（1）As of July 30^th, 2020, 71 patients were finally included after follow-ups for statistical analysis with one drop-out case in the treatment group（n=36） and two drop-out cases in the control group（n=35）.（2）ThemP FS of the treatment group and the control group were 15. 40 months and 13.07 months respectively,with significant difference between the two groups（ P = 0.024,HR = 0.575）;（3）The MST of the treatment group and the control group were 29.90 months and25.07 months respectively,with significant difference between the two groups（ P = 0. 045,HR = 0. 580）.（4） Multivariate analysis showed that combined treatment of traditional Chinese medicine,first-line Icotinib treatment, previous radical resection of lung cancer, and fewer comorbidities were independent protective factors affecting the long-term survival and prognosis of elderly patients with EGFR-mutant advanced lung adenocarcinoma（ P<0.05）. Conclusion TCM syndrome differentiation and treatment combined with Icotinib can prolong the progression-free survival and overall survival of elderly patients with EGFR-mutant advanced lung adenocarcinoma. The first-line Icotinib treatment stage,radical resection of lung cancer and fewer comorbidities are also conducive to the long-term survival prognosis of elderly patients with advanced lung adenocarcinoma.更多还原