摘要
目的 研究基于贝伐珠单抗联合全脑放疗的非小细胞肺癌(NSCLC)脑转移患者中VEGFR2-V297I位点基因多态性对其疗效的影响及其相关性分析。方法 收集2015年6月—2017年6月汉中市中心医院接受贝伐珠单抗并联合全脑放疗的晚期NSCLC脑转移患者141例,详细记录患者的性别、年龄、病理分型、ECOG得分、EGFR突变类型及生存资料,比较不同VEGFR2-V297I基因型患者基于贝伐珠单抗联合全脑放疗后进展及生存情况。结果 141例肺癌患者中有83例(58.87%)携带有CC基因型,49例(34.75%)携带有CT基因型,9例(6.38%)携带有TT基因型;符合Hardy-Weinberg平衡定律(χ^(2)=0.21,P=0.90);近期疗效评价:CC型和CT/TT型患者的客观缓解率分别为48.19%和48.28%,疾病控制率分别为89.16%和91.38%,差异均无统计学意义(P>0.05);携带有CC基因型患者的中位无进展生存期(PFS)为9.012个月(95%CI:8.260~9.764),携带有CT/TT型患者中位PFS为6.741(95%CI:5.787~7.695)个月(Log-rank=10.240,P=0.001);携有CC基因的中位总生存期(OS)为19.236(95%CI:18.176~20.295)个月,携带有CT/TT型患者中位OS为17.285(95%CI:16.175~18.395)个月(Log-rank=5.456,P=0.02);Cox比例风险回归模型显示年龄、性别、ECOG评分、VEGFR2-V297I位点均是影响患者PFS的独立危险因素。结论 VEGFR2-V297I位点基因多态性影响NSCLC脑转移患者基于贝伐珠单抗联合全脑放疗的疗效,CT/TT基因型是其进展与死亡的独立危险因素。
Objective To investigate the effect of VEGFR2-V297 I gene polymorphism on the efficacy and its correlation with bevacizumab combined with whole brain radiotherapy in non-small cell lung cancer(NSCLC) patients with brain metastasis.Methods A total of 141 advanced NSCLC patients with brain metastasis who were admitted to Hanzhong Central Hospital from June 2015 to June 2017 and received bevacizumab combined with whole brain radiotherapy were collected.Their sex,age,pathological type,ECOG score,EGFR mutant and survival data were recorded.After bevacizumab combined with whole brain radiotherapy,the progress and survival of patients with different VEGFR2-V297 I genotypes were compared.Results Among the 141 patients with gastric cancer,there were 83 patients(58.87%) with CC genotype,49 patients(34.75%) with CT genotype,and 9 patients(6.38%) with TT genotype,which was consistent with Hardy-Weinberg Law of equilibrium(χ^(2)=0.21,P=0.90).For evaluation of recent curative effects,the objective response rates of patients with CC and CT/TT genotype were 48.19% and 48.28%,respectively,and the disease control rates were 89.16% and 91.38%,respectively,without statistical difference(P>0.05).The median progress free survival(PFS) for CC genotype carriers was 9.012 months(95% CI:8.260—9.764),and the median PFS for patients with CT/TT genotype carriers was 6.741 months(95% CI:5.787—7.695)(Log-rank=10.240,P=0.001).The median OS for CC genotype carriers was 19.236 months(95% CI:18.176—20.295),and the median OS for CT/TT genotype carriers was 17.285 months(95% CI:16.175—18.395)(Log-rank=5.456,P=0.02).According to the Cox proportional hazard regression model,age,sex,ECOG score,and VEGFR2-V297 I locus were independent risk factors affecting PFS in patients.Conclusions VEGFR2-V297 I gene polymorphism can affect the efficacy of bevacizumab combined with whole brain radiotherapy in NSCLC patients with brain metastasis.CT/TT genotype is an independent risk factor for its progression and death.
作者
李冬
岳成山
胡勇
董学良
王利雄
LI Dong;YUE Chengshan;HU Yong;DONG Xueliang;WANG Lixiong(Department of Radiotherapy,Hanzhong Central Hospital,Hanzhong,Shaanxi 723000,China;School of Clinical Medicine,Xi'an Medical College,Xi'an,Shaanxi 710000)
出处
《徐州医科大学学报》
CAS
2022年第4期248-254,共7页
Journal of Xuzhou Medical University
基金
陕西省重点研发计划(2017SF-235)。
