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[目的]探讨酪氨酸激酶抑制剂(TKI)与化疗异时联合治疗晚期肺腺癌患者的疗效和不良反应。[方法]收集66例晚期肺腺癌患者,应用含铂2药化疗,疾病进展时予TKI吉非替尼或厄罗替尼治疗,或TKI初始治疗进展后使用化疗;交替进行。总生存时间及不良反应为主要观察指标。[结果]66例患者中,58例是化疗—TKI治疗模式,再化疗的有效率为15.5%,8例是TKI—化疗模式,再次TKI的有效率为25.0%,稍高于化疗—化疗模式患者中第二次治疗的有效率(12.7%)(χ2=2.6,P=0.08)。化疗—TKI治疗与TKI—化疗患者的中位总体生存期(OS)无明显差异(18.3个月vs 17.5个月)(P=0.44),但明显长于化疗—化疗患者(6.9个月)(P=0.0001)。交替治疗患者的3~4度不良反应与对照人群相似。[结论]晚期肺腺癌患者TKI与化疗交替联合治疗能提高有效率,明显延长生存时间,与交替方式(给药顺序)无关。
[Objective] To investigate the efficacy and adverse reactions of tyrosine kinase inhibitor (TKI) combined with chemotherapy in patients with advanced lung adenocarcinoma. [Methods] Sixty-six patients with advanced lung adenocarcinoma were recruited and treated with platinum-based chemotherapy. The patients were treated with gefitinib or erlotinib when the disease progressed, or were treated with chemotherapy after the initial treatment of TKI. Total survival time and adverse reactions as the main observation. [Results] Among the 66 patients, 58 were chemotherapy-TKI treatment regimens, and the effective rate of re-chemotherapy was 15.5%. TKI-chemotherapy was used in 8 of 8 patients. The effective rate of TKI was 25.0%, slightly higher than that of chemotherapy-chemotherapy The second treatment in patients was effective (12.7%) (χ 2 = 2.6, P = 0.08). There was no significant difference (P = 0.44) between the chemotherapy-TKI treatment and the median overall survival (OS) of patients treated with TKI-chemotherapy (P = 0.44) = 0.0001). Patients with alternating 3 to 4 degrees of adverse reactions and control groups similar. [Conclusions] The combination of TKI with chemotherapy in patients with advanced lung adenocarcinoma can improve the efficiency, prolong the survival time significantly, and has nothing to do with the alternation method (order of administration).