摘要
目的探讨化疗和EGFR-TKI新辅助治疗方案对ⅢA期EGFR突变肺腺癌疗效及安全性的影响。方法研究对象选取我院2013年2月-2016年2月收治ⅢA期EGFR突变肺腺癌患者共106例,以随机数字表法分为化疗组(53例)和靶向治疗组(53例),分别采用培美曲塞+铂类和厄洛替尼行新辅助治疗;比较两组缓解率、组织学评级有效率、不良反应发生率,手术相关临床指标水平,术后并发症发生率及随访生存率。结果靶向治疗组缓解率和组织学评级有效率均显著高于化疗组(P<0.05);靶向治疗组消化道反应和骨髓抑制发生率均显著低于化疗组(P<0.05);靶向治疗组皮疹发生率显著高于化疗组(P<0.05);两组口腔黏膜炎、周围神经炎及甲沟炎发生率比较差异无显著性(P>0.05);两组手术切除率、术中出血量及引流管拔除时间比较差异无显著性(P>0.05);两组术后并发症发生率比较差异无显著性(P>0.05);同时靶向治疗组中位总生存时间均显著长于化疗组(P<0.05)。结论相较于化疗方案,EGFR-TKI方案用于ⅢA期EGFR突变肺腺癌新辅助方案,能够显著提高总体疗效,降低消化道和骨髓抑制发生率,并有助于延长生存时间。
Objective To investigate the influence of clinical efficacy and safety of neoadjuvant therapy for chemotherapy and EGFR-TKI in treatment of lung adenocarcinoma complicated with EGFR mutant at stage Ⅲ. Methods 106 patients with lung adenocarcinoma complicated with EGFR mutant at stage Ⅲ were chosen from February 2013 to February 2016 in our hospital and randomly divided into 2 groups including the chemotherapy group (53 patients) with chemotherapy for neoadjuvant therapy and the target group (53 patients) with EGFR-TKI for neoadjuvant therapy. Their remission rate, effective rate of histological grade, adverse reactions incidence, the levels of operative related clinical indicators, postoperative complications incidence and survival rate during follow-up were compared between the two groups. Results The remission rate and effective rate of histological grade were significantly higher in the target group than in the chemotherapy group ( P< 0.05). The incidence of digestive tract reaction and myelosuppression was significantly lower in the target group than in the chemotherapy group ( P< 0.05). The rash incidence was significantly higher in the target group than in the chemotherapy group ( P< 0.05). There was no significant difference in the incidence of oral mucositis, peripheral neuritis and parotitis, surgical resection rate, intraoperative blood loss and drainage tube removal time between the two groups ( P> 0.05). There was no significant difference in the postoperative complications incidence between the two groups ( P> 0.05). The median OS was significantly longer in the target group than in the chemotherapy group ( P< 0.05). Conclusion Compared with chemotherapy for neoadjuvant therapy, EGFR-TKI for neoadjuvant therapy in treatment of patients with lung adenocarcinoma complicated with EGFR mutant at stage Ⅲ can efficiently improve overall clinical efficacy, reduce the incidence of gastrointestinal and myelosuppression and be helpful to prolonging survival time.
作者
宁泽
陈睿
陈柯宏
杨永胜
NING Ze;CHEN Rui;CHEN Ke-hong;YANG Yong-sheng(Department of Hematology, Red Cross Society Hospital of Chongqing, Chongqing 400020, China)
出处
《临床肺科杂志》
2019年第5期915-918,共4页
Journal of Clinical Pulmonary Medicine
关键词
新辅助
化疗
EGFR
肺癌
腺癌
neoadjuvant
chemotherapy
EGFR
lung cancer
adenocarcinoma
