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目的探讨吉非替尼联合同步放疗治疗EGFR突变型转移性非小细胞肺癌的疗效及安全性。方法选取2013年12月至2014年12月间扬州大学附属靖江市人民医院收治的80例EGFR突变型转移性非小细胞肺癌患者,采用随机数表法分为观察组和对照组,每组40例。观察组患者在调强放射治疗基础上采用吉非替尼治疗,对照组患者采用调强放射治疗。比较两组患者的临床疗效及不良反应,随访25个月,观察两组患者生存情况。结果治疗4周期后,观察组患者治疗有效率(57.5%)及疾病控制率(80.0%)均显著高于对照组的35.0%和62.5%,差异均有统计学意义(均P<0.05)。两组患者常见的不良反应包括白细胞减少、血小板减少、贫血、恶心、呕吐、食欲不振和皮疹等,以Ⅰ~Ⅱ级为主,观察组患者不良反应发生率为95.0%(38/40),与对照组的90.0%(36/40)比较,差异无统计学意义(P>0.05)。观察组患者中位生存时间为15.4个月,对照组为12.3个月。观察组患者1年生存率为71.1%,对照组为60.4%。结论吉非替尼联合同步放射治疗,能够提高EGFR突变型转移性非小细胞肺癌的临床疗效,且安全性较好。
Objective To investigate the efficacy and safety of gefitinib combined with concurrent radiotherapy in the treatment of EGFR mutant metastatic non-small cell lung cancer. Methods Eighty EGFR mutant NSCLC patients admitted to Jingjiang People’s Hospital affiliated to Yangzhou University from December 2013 to December 2014 were divided into observation group and control group with random number table example. Patients in the observation group were treated with gefitinib based on intensity-modulated radiation therapy while those in the control group were treated with intensity-modulated radiation therapy. The clinical efficacy and adverse reactions of the two groups were compared and followed up for 25 months to observe the survival of the two groups. Results After 4 cycles of treatment, the effective rate (57.5%) and disease control rate (80.0%) in the observation group were significantly higher than those in the control group (35.0% and 62.5%, both P <0.05). The common adverse reactions of the two groups included leukopenia, thrombocytopenia, anemia, nausea, vomiting, loss of appetite and skin rashes. Grade Ⅰ ~ Ⅱ were the major adverse reactions in the two groups. The incidence of adverse reactions in the observation group was 95.0% (38/40) Compared with 90.0% (36/40) in control group, the difference was not statistically significant (P> 0.05). The median survival time was 15.4 months in the observation group and 12.3 months in the control group. The 1-year survival rate was 71.1% in the observation group and 60.4% in the control group. Conclusion Gefitinib combined with concurrent radiotherapy can improve the clinical efficacy of EGFR mutant metastatic non-small cell lung cancer with good safety.