Abstract
背景与目的表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor tyrosine kinase inhibitor, EGFR-TKI)是化疗失败的晚期非小细胞肺癌(non-small cell lung cancer, NSCLC)的标准二三线治疗方案,亦是EGFR突变患者一线治疗的最佳选择,但对初始治疗后进展的患者,在治疗过程中能否再次使用TKI是目前的关注热点。本研究旨在探讨晚期NSCLC初始治疗后再次应用EGFR-TKI的疗效。方法本研究回顾性分析了71例晚期或术后复发的NSCLC初始EGFR-TKI治疗后,再次应用TKI的疗效。结果71例再次应用TKI的患者中,部分缓解(partial response, PR)为7%,稳定(stable disease, SD)为36.6%,(progressive disease, PD)为56.3%,疾病控制率(disease contral rate, DCR)为43.7%,无进展生存期(progression free survival, PFS) > 3个月者26例(36.6%)。EGFR 21外显子突变、初始TKI缓解期≥6个月、两次TKI的间隔期≥3个月与更长的PFS相关,单因素COX回归分析,P值分别为0.034、0.013、0.046。结论TKI治疗失败的NSCLC患者再次应用TKI,部分患者仍可获得疾病控制。EGFR 21外显子突变、初始TKI缓解期≥6个月、两次TKI间隔期≥3个月的患者更可能从再次应用TKI中获益。
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