摘要
目的探讨阿美替尼、吉非替尼治疗表皮生长因子受体(EGFR)突变局部晚期非小细胞肺癌(NSCLC)的效果及预后。方法选取2019年3月至2022年9月确诊的100例EGFR突变局部晚期NSCLC,根据治疗方式不同分为A组(n=57)和B组(n=43),A组采用阿美替尼治疗,B组采用吉非替尼治疗,均持续治疗2个周期。比较2组的客观缓解率(ORR)和疾病控制率(DCR)、治疗前后血清EGFR水平和免疫球蛋白指标[免疫球蛋白M(IgM)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)]、毒副反应发生率,所有患者随访12~42个月,绘制生存曲线,比较2组中位总生存期(OS)和中位无进展生存期(PFS)。结果A组ORR和DCR分别为28.07%和77.19%,B组分别为11.63%和44.19%,差异均有统计学意义(P<0.05)。治疗后,A组血清EGFR水平较B组低,IgM、IgA和IgG水平较B组高,差异有统计学意义(P<0.05)。A组<3级毒副反应发生率为71.93%,≥3级毒副反应发生率为21.05%,B组<3级毒副反应发生率为48.84%,≥3级毒副反应发生率为41.86%,差异有统计学意义(P<0.05)。A组中位OS和中位PFS分别为16.9个月和5.8个月,B组中位OS和中位PFS分别为10.5个月和4.0个月,差异有统计学意义(P<0.05)。结论与吉非替尼比较,阿美替尼治疗EGFR突变局部晚期NSCLC患者效果更好,可以更好控制病情发展,改善EGFR水平和免疫指标,提高患者生存率,且具有一定的安全性。
Objective To investigate the efficacy and prognosis of Almonertinib and Gefitinib in the treatment of locally advanced non-small cell lung cancer(NSCLC)with epidermal growth factor receptor(EGFR)mutation.Methods A total of 100 patients diagnosed with locally advanced NSCLC with EGFR mutation from March 2019 to September 2022 were selected and divided into group A(n=57)and group B(n=43)according to different treatment methods.Group A was treated with Almonertinib and group B was treated with Gefitinib,both of which were treated for 2 cycles.Objective response rate(ORR),disease control rate(DCR),serum EGFR level,immunoglobulin levels[immunoglobulin M(IgM),immunoglobulin A(IgA),immunoglobulin G(IgG)],and incidence of toxic and side effects were compared between the two groups.All patients were followed up for 12 to 42 months,and survival curves were drawn.Median overall survival(OS)and median progression-free survival(PFS)were compared between the two groups.Results ORR and DCR were 28.07%and 77.19%in group A,and 11.63%and 44.19%in group B,respectively,with statistical significance(P<0.05).After treatment,the serum EGFR levels in group A were lower than those in group B,while the IgM,IgA and IgG levels were higher than those in group B,with statistical significance(P<0.05).The incidence of grade<3 and≥3 toxic and side effects were 71.93%and 21.05%respectively in group A,and 48.84%and 41.86%respectively in group B,with statistical significance(P<0.05).The median OS and PFS were 16.9 months and 5.8 months respectively in group A,and 10.5 months and 4.0 months respectively in group B,showing significant difference(P<0.05).Conclusion Compared with Gefitinib,Almonertinib is more effective in the treatment of patients with locally advanced NSCLC with EGFR mutation,which can better control disease development,improve EGFR level and immune indexes,and improve patient survival rate,and has a certain safety.
作者
曾含梅
王利民
ZENG Hanmei;WANG Limin(Department of Oncology,Leiyang People's Hospital,Leiyang,Hunan 421800,China;Department of Neurology,Leiyang People's Hospital,Leiyang,Hunan 421800,China)
出处
《临床误诊误治》
CAS
2024年第10期39-43,共5页
Clinical Misdiagnosis & Mistherapy
基金
国家卫生健康委“十四五”规划全国重点课题(YYDF3621)。
关键词
非小细胞肺癌
阿美替尼
吉非替尼
表皮生长因子受体
免疫球蛋白A
治疗效果
药物毒性
无进展生存时间
Non-small cell lung cancer
Almonertinib
Gefitinib
Epidermal growth factor receptor
Immunoglobulin A
Treatment effectiveness
Drug toxicity
Progression-free survival
