摘要
目的探讨射波刀(CK)联合表皮生长因子受体(EGFR)-酪氨酸激酶抑制剂(TKI)一线治疗EGFR突变晚期非小细胞肺癌(NSCLC)患者的疗效并分析影响因素。方法收集138例行CK联合EGFR-TKI一线治疗的EGFR突变晚期NSCLC患者的病历资料。采用Kaplan-Meier法分析不同因素对患者无进展生存期(PFS)和总生存期(OS)的影响。采用Cox回归模型分析患者预后的影响因素。结果138例患者中位随访时间为55.8个月,中位PFS、中位OS分别为26个月和47个月,12、24、36个月无进展生存率分别为77.5%、55.1%和36.0%,12、24、36、60个月总生存率分别为98.1%、82.0%、68.3%和28.3%。Cox回归分析结果显示,寡转移、年龄≥60岁、放靶异步治疗均是CK联合TKI一线治疗Ⅳ期NSCLC患者OS的独立保护因素。结论与单纯EGFR-TKI治疗比较,CK联合TKI一线治疗更能改善EGFR突变晚期NSCLC患者的预后,临床安全性好。寡转移、年龄≥60岁、放靶异步治疗均是CK联合TKI一线治疗Ⅳ期NSCLC患者OS的独立保护因素。
Objective To investigate the clinical efficacy and influencing factors of cyberknife(CK)combined with epidermal growth factor receptor-tyrosine kinase inhibitor(EGFR-TKI)in the first line treatment of non-small cell lung cancer(NSCLC)with EGFR mutation.Method Medical records of 138 NSCLC patients with EGFR mutation who re-ceived first line treatment of CK+EGFR-TKI were collected.The influencing of different factors on progression-free sur-vival(PFS)and overall survival(OS)were analyzed by Kaplan-Meier method and influencing factors of prognosis were analyzed by Cox regression model.Result The median follow-up time of 138 cases was 55.8 months,the median PFS and OS were 26 months and 47 months respectively.The PFS rates of patients in 12,24 and 36 months were 77.5%,55.1%and 36.0%respectively,and corresponding OS rates in 12,24,36,60 months were 98.1%,82.0%,68.3%and 28.3%,respectively.Cox regression analysis showed that oligometastasis,age≥60 years,asynchronous treatment of CK and TKI were independent favorable factors of OS during the first line treatment of CK+TKI in stage IV NSCLC.Conclu-sion Compare with EGFR-TKI therapy,the first line treatment of CK+TKI can significantly improve the prognosis of advanced NSCLC patients with EGFR mutation,with good clinical safety.Oligometastasis,age≥60 years,asynchronous treatment of CK and TKI are independent favorable factors of OS during the first line treatment of CK+TKI in stage IV NSCLC.
作者
谢有科
梁广霞
肖慧敏
韦婷婷
唐阳
卢幻真
练祖平
XIE Youke;LIANG Guangxia;XIAO Huimin;WEI Tingting;TANG Yang;LU Huanzhen;LIAN Zuping(Department of Oncology,Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning 530000,Guangxi,China;Department of Oncology,the Fifth Affiliated Hospital of Zunyi Medical University,Zhuhai,Zhuhai 519100,Guangdong,China;Cyberknife Therapic Center,Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning 530000,Guangxi,China)
出处
《癌症进展》
2023年第17期1934-1940,共7页
Oncology Progress
关键词
晚期非小细胞肺癌
射波刀
酪氨酸激酶抑制剂
表皮生长因子受体
预后
advanced non-small cell lung cancer
cyberknife
tyrosine kinase inhibitor
epidermal growth factor re-ceptor
prognosis
