Objective To compare and analyze the overall survival (OS) of patients with advanced non-small-cell lung cancer and EGFR mutated-unknown after the treatment of EGFR-TKI and intercalated combination of chemotherapy and EGFR-TKI.Methods Clinical data of 58 patients with advanced histopathology confirmed non-small-cell lung cancer and EGFR mutated-unknown treated in the Second Affiliated Hospital of Nanjing Medical University from January 2010 to December 2014 was analyzed retrospectively.36 patients were treated with intercalated combination of chemotherapy and EGFR-TKIs (rotational therapy group) and 22 patients were treated with chemotherapy alone (chemotherapy group).The survival rate was calculated by Kaplan-Meier method and compared by Log-rank test.Cox single and multivariate prognosis analysis was performed.Results 22 patients received chemotherapy,the median age was 28 years,the mean age was 30.444 (*) ± 5.122.36 patients received intercalated combination of chemotherapy and EGFR-TKI,the median age was 36 years,the mean age was 42.740 (*) ± 3.668.There was significant difference in OS between the intercalated combination of chemotherapy and EGFR-TKIs and chemotherapy groups (P=0.0413).Drug treatment modalities was the only predictor of OS (P=0.047,0.008),while cigarette smoking,age,pathology,and sex were not (P ＞ 0.05).Conclusion Intercalated combination of chemotherapy and EGFR-TKIs treatment is better than chemotherapyin the advanced non-small-cell lung cancer with EGFR mutated-unknown.%目的 对比分析非小细胞肺癌患者接受表皮生长因子受体-酪氨酸激酶抑制剂(EGFR-TKIs)和化疗交替治疗与单纯化疗的总生存率.方法 回顾性分析2010年1月～2014年12月收治的58例EGFR基因状态不明、经组织病理学证实的晚期非小细胞肺癌患者的临床资料.其中,36例患者采用EGFR-TKIs和化疗交替治疗(交替治疗组),22例患者采用单纯化疗(单纯化疗组).采用Log-rank检验组间生存差异,Kaplan-Meier法进行生存分析,Cox比例风险模型进行单因素和多因素分析.结果 交替治疗组患者平均生存时间为[42.740(*)±3.668]个月,中位生存时间为36个月;单纯化疗组平均生存时间为[30.444(*)±5.122]个月,中位生存时间为28个月;经Log-rank检验,交替治疗组患者预后好于单纯化疗组(P=0.0413);Cox回归分析得出接受治疗的方法是影响肺癌预后的独立因素(P=0.047、0.008),而吸烟状况、病理类型、年龄、性别等对预后没有影响(P＞0.05).结论 EGFR-TKI和化疗交替进行能有效延长EGFR突变状态不明的NSCLC患者生存.
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