Park Dong Il, Kim Sun Young, Kim Ju Ock, Jung Sung Soo, Park Hee Sun, Moon Jae Young, Chung Chae Uk, Kim Song Soo, Seo Jae Hee, Lee Jeong Eun
Division of Pulmonary, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea.
Department of Radiology, Chungnam National University Hospital, Daejeon, Korea.
Tuberc Respir Dis (Seoul). 2015 Oct;78(4):315-20. doi: 10.4046/trd.2015.78.4.315. Epub 2015 Oct 1.
The efficacy of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) therapy can be measured based on the rate of treatment response, based on the Response Evaluation Criteria in Solid Tumors (RECIST) criteria or progression-free survival (PFS). However, there are some patients harboring sensitive EGFR mutations who responded poorly to EGFR-TKI therapy. In addition, there is variability in the PFS after EGFR-TKI treatment.
We performed a retrospective analysis of the medical records of 85 patients with non-small cell lung cancer, who had achieved a stable disease or better response at the first evaluation of treatment response, after receiving a 2-month course of gefitinib. We calculated the tumor shrinkage rate (TSR) by measuring the longest and perpendicular diameter of the main mass on computed tomography before, and 2 months after, gefitinib therapy.
There was a significant positive correlation between the TSR and PFS (R=0.373, p=0.010). In addition, a simple linear regression analysis showed that the TSR might be an indicator for the PFS (B±standard error, 244.54±66.79; p=0.001). On univariate analysis, the sex, histologic type, smoking history and the number of prior chemotherapy regimens, were significant prognostic factors. On multivariate regression analysis, both the TSR (β=0.257, p=0.029) and adenocarcinoma (β=0.323, p=0.005) were independent prognostic factors for PFS.
Our results showed that the TSR might be an early prognostic indicator for PFS in patients receiving EGFR-TKI therapy.
表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKI）疗法的疗效可根据治疗反应率来衡量，依据实体瘤疗效评价标准（RECIST）标准或无进展生存期（PFS）。然而，有一些携带敏感EGFR突变的患者对EGFR-TKI疗法反应不佳。此外，EGFR-TKI治疗后的PFS存在变异性。
我们对85例非小细胞肺癌患者的病历进行了回顾性分析，这些患者在接受2个月吉非替尼疗程后，首次评估治疗反应时达到疾病稳定或更好的反应。我们通过在吉非替尼治疗前和治疗2个月后测量计算机断层扫描上主要肿块的最长直径和垂直直径来计算肿瘤缩小率（TSR）。
TSR与PFS之间存在显著正相关（R = 0.373，p = 0.010）。此外，简单线性回归分析表明TSR可能是PFS的一个指标（B±标准误，244.54±66.79；p = 0.001）。单因素分析中，性别、组织学类型、吸烟史和既往化疗方案的数量是显著的预后因素。多因素回归分析中，TSR（β = 0.257，p = 0.029）和腺癌（β = 0.323，p = 0.005）都是PFS的独立预后因素。
我们的结果表明，TSR可能是接受EGFR-TKI治疗患者PFS的早期预后指标。
