Objective To observe the therapeutic effect and safety of epidermal growth factor receptor and tyrosinase inhibitor ( EGFR-TKI ) in the treatment of patients with advanced EGFR-TKI resistance to non small cell lung cancer ( NSCLC) .Methods Collected advanced 79 EGFR-TKI resistant NSCLC patients from January 2010 to December 2013 in Liao-ning Dandong Central Hospital, they were randomly divided into sequential group (first chemotherapy, then EGFR-TKI treat-ment) with 39 cases and chemotherapy group (treated with chemotherapy) with 40 cases, compared two groups'tumor mark-ers, near future curative effect, long-term efficacy and adverse reactions.Results Short term efficacy response rate (20.5%) in the sequential chemotherapy group (10.0%) was higher than chemotherapy group, but the difference was not statistically significant ( P >0.05); sequential group overall response rate (74.4%) was significantly higher than that chemotherapy group (50.0%), the difference was statistically significant ( P <0.05).Sequential progression-free median survival time (PFS) was (3.4 ±0.9) months, which was significantly longer than chemotherapy group (2.5 ±0.8) months ( t =3.981, P <0.05).Sequential group's overall survival time (OS) was (6.4 ±1.2) months, which was significantly longer than chemotherapy group (4.3 ±1.5) months, and the difference was statistically significant ( t =4.182, P <0.05).After treat-ment, serum carcinoembryonic antigen ( CEA) , neuron-specific enolase ( NSE) , cytokeratin 19 fragment ( CYFRA21-1 ) in sequential group were significantly lower than the chemotherapy group ( P <0.05) .Between the two groups, the incidence of adverse reactions and the severity did not show significant differences ( P >0.05).Conclusion After chemotherapy, using EGFR-TKI treatment for advanced EGFR-TKI resistant NSCLC patients can prolong the survival time of patients and it is safe and reliable.%目的 观察化疗后再次使用表皮生长因子受体—酪氨酸酶抑制剂(EGFR-TKI)治疗晚期获得性EG-FR-TKI耐药非小细胞肺癌(NSCLC)患者的临床效果及安全性.方法 收集2010年1月—2013年12月辽宁省丹东中心医院诊治晚期获得性EGFR-TKI耐药NSCLC患者79例,采用随机数字表法分为序贯组(先化疗,再采用EGFR-TKI治疗)39例和化疗组(单纯给予化疗)40例,对比2组肿瘤标记物、近期疗效、远期疗效及不良反应发生情况.结果 序贯组的近期疗效缓解率(20照.5%)高于化疗组的(10.0%),但差异无统计学意义(P>0.05);序贯组的总有效率(74.4%)显著高于化疗组(50.0%),差异具有统计学意义(P<0.05).序贯组的无进展中位生存时间(PFS)为(3.4±0.9)个月,显著长于化疗组的(2.5±0.8)个月(t=3.981,P<0.05).序贯组患者总生存时间(OS)为(6.4±1.2)个月,显著长于化疗组的(4.3±1.5)个月,且差异具有统计学意义(t=4.182,P<0.05).治疗后序贯组的血清癌胚抗原(CEA)、经元特异性烯醇化酶(NSE)、细胞角质蛋白19片段(CYFRA21-1)水平显著低于化疗组(P<0.05).2组间不良反应发生率及严重程度差异均无统计学意义(P>0.05).结论 化疗后再次使用EGFR-TKI治疗晚期获得性EGFR-TKI耐药NSCLC患者可以延长患者的生存时间且安全可靠.
展开▼
