文章摘要
高志强,马美丽,黄艾弥,滕家俊,乔 荣,王韡旻,顾爱琴,钟 华,韩宝惠,施春雷.吉非替尼治疗EGFR突变型晚期肺腺癌的近期疗效、毒副反应及疗效的影响因素分析[J].,2021,(8):1555-1558
吉非替尼治疗EGFR突变型晚期肺腺癌的近期疗效、毒副反应及疗效的影响因素分析
The Short-term Efficacy, Toxic and Side Effects and Influencing Factors of Gefitinib in the Treatment of EGFR Mutant Advanced Lung Adenocarcinoma
投稿时间:2020-08-23  修订日期:2020-09-18
DOI:10.13241/j.cnki.pmb.2021.08.034
中文关键词: 吉非替尼  表皮生长因子受体  突变型  晚期  肺腺癌  毒副反应  疗效  影响因素
英文关键词: Gefitinib  Epidermal growth factor receptor  Mutant  Advanced  Lung adenocarcinoma  Toxic and side effects  Efficacy  Influencing factors
基金项目:CSCO-齐鲁肿瘤研究基金(Y-Q201802-062);上海市自然科学基金项目(12ZR1428800)
作者单位E-mail
高志强 上海市胸科医院/上海交通大学附属胸科医院呼吸内科 上海 200030 gaozhiqiang197507@163.com 
马美丽 上海市胸科医院/上海交通大学附属胸科医院呼吸内科 上海 200030  
黄艾弥 上海市胸科医院/上海交通大学附属胸科医院呼吸内科 上海 200030  
滕家俊 上海市胸科医院/上海交通大学附属胸科医院呼吸内科 上海 200030  
乔 荣 上海市胸科医院/上海交通大学附属胸科医院呼吸内科 上海 200030  
王韡旻 上海市胸科医院/上海交通大学附属胸科医院呼吸内科 上海 200030  
顾爱琴 上海市胸科医院/上海交通大学附属胸科医院呼吸内科 上海 200030  
钟 华 上海市胸科医院/上海交通大学附属胸科医院呼吸内科 上海 200030  
韩宝惠 上海市胸科医院/上海交通大学附属胸科医院呼吸内科 上海 200030  
施春雷 上海市胸科医院/上海交通大学附属胸科医院呼吸内科 上海 200030  
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中文摘要:
      摘要 目的:探讨吉非替尼治疗表皮生长因子受体(EGFR)突变型晚期肺腺癌的近期疗效、毒副反应及疗效的影响因素。方法:选取2018年4月~2019年6月期间我院收治的EGFR突变型晚期肺腺癌患者97例。所有患者均给予吉非替尼治疗,观察其近期疗效及毒副反应情况。采用单因素和多因素 Logistic回归分析疗效的影响因素。结果:97例患者全部如期完成治疗,近期疗效评价:完全缓解(CR)、部分缓解(PR)、病情稳定(SD)、病情进展(PD)率分别为9.28%(9/97)、24.74%(24/97)、31.96%(31/97)、34.02%(33/97)。根据近期疗效结果将患者分为有效组(CR+PR,n=33)和无效组(SD+PD,n=64)。本研究中患者的毒副反应多为 I、Ⅱ度非血液学毒性,最常见的是皮肤毒性,如皮疹等;其他毒副反应如胃部不适、腹泻等,经对症治疗后均能缓解。单因素分析结果显示,吉非替尼治疗EGFR突变型晚期肺腺癌的疗效与性别、肿瘤临床分期、骨转移、肿瘤直径有关(P<0.05),而与年龄、肾上腺转移、脑转移、吸烟史无关(P>0.05)。多因素Logistic回归分析结果显示,性别为男性、肿瘤分期Ⅳ期是影响吉非替尼治疗EGFR突变型晚期肺腺癌疗效的危险因素(OR=1.473、2.042,P<0.05)。结论:吉非替尼治疗EGFR突变型晚期肺腺癌具有不错的近期疗效,不良反应较少,性别为男性、肿瘤分期Ⅳ期是影响吉非替尼治疗EGFR突变型晚期肺腺癌疗效的危险因素。
英文摘要:
      ABSTRACT Objective: To investigate the short-term efficacy, toxic and side effects and influencing factors of gefitinib in the treatment of epidermal growth factor receptor (EGFR) mutant advanced lung adenocarcinoma. Methods: From April 2018 to June 2019, 97 patients with EGFR mutant advanced lung adenocarcinoma who were admitted to our hospital from April 2018 to June 2019 were selected. All patients were treated with gefitinib, and the short-term efficacy and toxic and side effects were observed. Univariate and Multivariate logistic regression was used to analyze the influencing factors of the efficacy. Results: All 97 patients were completed the treatment as scheduled. The short-term efficacy evaluation: the complete remission (CR) rate, the partial remission (PR) rate, stable disease (SD) rate, progression disease (PD) rate were 9.28% (9/97), 24.74% (24/97), 31.96% (31/97), 34.02% (33/97) respectively. The patients were divided into the effective group (CR+PR, n=33) and the ineffective group (SD+PD, n=64)according to the short-term results . The toxic and side effects in this group were mostly grade I and II non hematologic toxicity, the most common was skin toxicity, such as rash, etc; other toxic and side effects, such as stomach discomfort, diarrhea, etc, which could be relieved after symptomatic treatment. The results of univariate analysis showed that gefitinib in the treatment of EGFR mutant advanced lung adenocarcinoma were related to gender, clinical stage, bone metastasis and tumor diameter (P<0.05), but not related to age, adrenal metastasis, brain metastasis and smoking history (P>0.05). The results of multivariate Logistic regression analysis showed that gender for male, tumor stage Ⅳ treatment were independent risk factors for the efficacy of EGFR mutant advanced lung adenocarcinoma (OR=1.473, 2.042, P<0.05). Conclusion: Gefitinib has a good short-term effect in the treatment of EGFR mutant advanced lung adenocarcinoma,which has less toxic and side effects, gender for male, tumor stage IV are risk factors affecting the effect of EGFR mutant advanced lung adenocarcinoma.
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