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目的:探讨吉非替尼用于晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)二线或三线治疗对患者生存期的影响。方法:回顾性分析106例晚期NSCLC患者的病历和随访资料,其中62例患者接受吉非替尼二线治疗,44例患者接受吉非替尼三线治疗。应用Kaplan-Meier法进行生存分析。结果:两组患者的性别(P=0.51)、年龄(P=0.91)、体能状况评分(P=0.42)、临床分期(P=0.18)、吸烟史(P=0.95)和病理类型(P=0.99)的差异无统计学意义。吉非替尼二线治疗和三线治疗患者的中位无进展生存期分别分别为2.9和3.2个月(P=0.757),有效率分别为17.7%和11.4%(P=0.665),疾病控制率分别为48.4%和54.5%(P=0.822)。吉非替尼二线治疗和三线治疗患者的中位总生存期分别为24.0和21.0个月(P=0.524)。二线治疗获得疾病控制的30例患者以及三线治疗获得疾病控制的24例患者的中位总生存期分别为29.7和22.2个月(P=0.611)。吉非替尼二线治疗与三线治疗的不良反应相似。结论:吉非替尼用于晚期NSCLC二线治疗和三线治疗的缓解率和生存获益无明显差异。
Objective: To investigate the effect of gefitinib on the survival of patients with second-line or third-line treatment of advanced non-small cell lung cancer (NSCLC). Methods: The clinical data and follow-up data of 106 patients with advanced NSCLC were retrospectively analyzed. Among them, 62 patients received gefitinib second-line therapy and 44 patients received gefitinib third-line therapy. Survival analysis was performed using Kaplan-Meier method. Results: There was significant difference in gender (P = 0.51), age (P = 0.91), physical status score (P = 0.42), clinical stage (P = 0.18), smoking history (P = 0.95) 0.99) the difference was not statistically significant. Median progression-free survival rates for gefitinib second and third-line treatment were 2.9 and 3.2 months, respectively (P = 0.757), with effective rates of 17.7% and 11.4%, respectively (P = 0.665) 48.4% and 54.5% (P = 0.822). Median overall survival was 24.0 and 21.0 months for both gefitinib and third-line gefitinib (P = 0.524). The median overall survival for 30 patients on second-line disease control and 24 patients on third-line disease control was 29.7 and 22.2 months, respectively (P = 0.611). Side effects of second-line gefitinib and third-line treatment were similar. CONCLUSION: There is no significant difference in response rate and survival benefit of gefitinib for second-line and third-line NSCLC.