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目的观察非小细胞肺癌(NSCLC)手术患者根治性术后表皮生长因子受体(EGFR)基因的突变情况,并分析不同EGFR基因状态对患者术后化疗与靶向治疗效果的影响。方法选取2011年1月至2014年12月51例高危ⅠB~ⅢA期根治术后NSCLC患者,按照EGFR基因型分为A组(23例,EGFR野生型,给予含铂两药化疗)、B组(16例,EGFR突变型,给予含铂两药化疗)和C组(12例,EGFR突变型,给予含铂两药化疗+靶向TKIs药物治疗)。观察维持治疗6、12、18个月时患者的无疾病生存期(DFS)、化疗和靶向TKI药物的不良反应情况。结果三组患者术后化疗、靶向治疗的不良反应发生率比较差异未见统计学意义(P>0.05);术后给予化疗+靶向TKI药物治疗的EGFR基因突变C组患者12、18个月的DFS显著优于A组和B组(P<0.05)。结论对根治性术后EGFR基因突变的NSCLC采用化疗+靶向TKI药物治疗不良反应小,可有效延长患者的DFS。
Objective To observe the mutations of epidermal growth factor receptor (EGFR) gene in patients with non-small cell lung cancer (NSCLC) after radical surgery and analyze the effect of different EGFR gene status on postoperative chemotherapy and targeted therapy. Methods Totally 51 NSCLC patients with high risk ⅠB-ⅢA radical resection from January 2011 to December 2014 were divided into group A (23 cases, wild-type EGFR, platinum-based chemotherapy) and group B (16 cases of EGFR mutation, given two platinum-containing chemotherapy) and group C (12 cases of EGFR mutation, given two platinum-containing chemotherapy + targeted TKIs drug treatment). Patients were observed for disease free survival (DFS) at 6, 12, and 18 months of maintenance treatment, as well as chemotherapy and adverse events targeting TKIs. Results There was no significant difference in the incidence of adverse reactions between the three groups after chemotherapy and targeted therapy (P> 0.05). There were 12,18 patients with EGFR mutation in group C after chemotherapy and targeted TKI treatment Month DFS was significantly better than the A and B group (P <0.05). Conclusions Chemotherapy + targeted TKI therapy for NSCLC with radical EGFR gene mutation after radical surgery is of little adverse effects and can effectively prolong DFS.