摘要
目的评价埃克替尼治疗表皮生长因子受体(EGFR)突变型晚期非小细胞肺癌(NSCLC)的疗效及对营养状况、免疫功能的影响。方法选取2015年2月至2017年7月EGFR突变型晚期非小细胞肺癌患者92例,接受埃克替尼治疗,评价其客观缓解率(ORR)、疾病控制率(DCR)及无进展生存期(PFS),比较治疗前、治疗后4周患者体质量指数(BMI)、白蛋白(ALB)、血红蛋白(Hb)、前白蛋白(PA)4项营养指标和T淋巴细胞亚群CD4^+、CD8^+、CD4^+/CD8^+3项免疫功能的变化,观察治疗后的毒副反应。结果患者接受埃克替尼治疗后PR(部分缓解)占31.5%(29/92),SD(疾病稳定)占65.2%(60/92),疾病进展(PD)占3.3%(3/92)。ORR为31.5%,DCR为96.7%。19外显子缺失突变的患者ORR优于21外显子L858错义突变及非经典突变(P<0.05),不吸烟的患者DCR优于吸烟患者(P<0.05),中位PFS14.0个月。女性、腺癌、美国东部肿瘤协作组(ECOG)评分低的患者中位PFS高于男性、鱗癌、ECOG评分高的患者(P<0.05)。治疗4周后,CD4^+、CD4^+/CD8^+水平明显升高,CD8^+水平明显降低,体质量指数、白蛋白、血红蛋白、前白蛋白明显升高,免疫功能和营养状况显著改善,差异有统计学意义(P<0.05)。结论埃克替尼治疗表皮生长因子受体突变型晚期NSCLC具有较好的近期疗效及生存获益,且不良反应小,耐受性好,有效改善患者营养状况及免疫功能。
Objective To evaluate the eficacy of icotinib in the treatment of epidermal growth factor receptor(EGFR)mutant advanced non-small cell lung cancer and its ffect on nuritional status and immune function.Methods 92 cases of EGFR mutant advanced non-small cell lung cancer treated in our hospital from February 2015 to July 2017 were selected and treated with icotinib.ORR(objective response rate),DCR(disease control rates)and PFS(progresion-free survival)were evaluated.The changes of four nurition indexes of body mass index(BMI),albumin(ALB),henmoglobin(HB),prealbumin(PA),as well as the changes of T-lymphocyte subsets CD4^+,CD8^+,CD4^+/CD8^+were compared 4 weeks after treatment.The side fects after treatment were observed.Results PR(partial response)accounted for 31.5%(29/92),and SD(stable disease)accounted for 65.2%(60/92).PD(progresion of disease)accounted for 3.3%(3/92).The ORR(objective response rate)was 31.5%and the DCR(disease control rate)was 96.7%.The ORR of the patients with exon 19 deletion mutation was significantly better than that of exon 21 L858 missense mutation and noncassical mutation(P<0.05).The DCR of the patients without smoking was significantly better than that of the patients with smoking(P<0.05)。The median PFS of the patients was 14.0 months.The PFS of women,adenocarcinoma and low-ECOG(Easterm Cooperative Oncology Group)were signifcanly higher than that of men,squamous cell carcinoma and high-ECOG.(P<0.05).Four wecks after treatment,the levels of CD4^+,CD4^+/CD8^+were signifcantly higher,CD8^+was signifcantly lower,BMI,albumin,hemoglobin,prealbumin were signifcantly higher,immune fiunction and nutritional status were significantly improved.The diference was saistically significant(P<0.05).Conclusion lcotinib has good short-term ficacy and survival benefis in the treatment of EGFR mutant advanced NSCLC,with less adverse reactions,good tolerance,and can improve the quality of life of patients.
出处
《浙江临床医学》
2020年第11期1544-1546,共3页
Zhejiang Clinical Medical Journal
关键词
埃克替尼
非小细胞肺癌
晚期
EGFR突变
疗效
营养状况
免疫功能
Icotinib
Non-small cell lung cancer
Advanced stage
EGFR mutation
Efficacy
Body condition
Nutritional status
Immume finction
