Zhou B O, Nie Jun, Yang Weidong, Huang Chenhong, Huang Y E, Zhao Hongfei
Department of Cardiothoracic Surgery, People's Hospital of China Three Gorges University, The First People's Hospital of Yichang, Yichang, Hubei 443000, P.R. China.
Department of Nephrology, People's Hospital of China Three Gorges University, The First People's Hospital of Yichang, Yichang, Hubei 443000, P.R. China.
Oncol Lett. 2016 Feb;11(2):1413-1417. doi: 10.3892/ol.2015.4066. Epub 2015 Dec 31.
Lung cancer is a malignancy with the highest incidence of morbidity and mortality worldwide. The lack of effective detection methods leads to the ineffectiveness of convetional therapy. The aim of the current study was to analyze the hydrothorax epidermal growth factor receptor (EGFR) mutation in patients with advanced non-small lung cancer (NSCLC) and malignant pleural effusion. A new method for clinical treatment was developed through a comparison of the difference of EGFR tyrosine kinase inhibitor (EGFR-TKI)-targeted therapy. Between January 2013 and January 2015, 68 cases diagnosed with advanced non-small lung cancer and malignant pleural effusion, were enrolled in the study. Previous first-line chemotherapeutic treatment schemes had been unsuccessful. EGFR 19 and EGFR 21 sites were detected for all the patients. Platinum-based drugs were provided for patients with wild-type EGFR. These patients served as the control group and underwent four cycles of treatments, with each cycle lasting 3 weeks. TKI medicine Gefitinib (Iressa™) was administered to patients with mutant EGFR tid, po, for a duration of 4-8 months. These patients served as the experimental group. There were 41 cases of EGFR mutations, of which 13 cases had EGFR 19 site mutations, 16 cases EGFR 21 site mutations, and the remaining 12 cases had 2 site mutations. EGFR mutations were not significant for gender, age, tumor type, stage and diameter (P>0.05). The results showed that the six-month survival rate, progression-free survival time (PFS), objective response rate (RP) and disease control rate (DCR) in the experimental group were higher than those in the control group. The drug side-effects in the experimental group indicated no statistical differences compared to the control group (P>0.05). The incidence of EGFR mutation was higher in patients with advanced non-small lung cancer and malignant pleural effusion. Targeted therapy improved the survival rate and was deemed to be a safe and effective method for patients with EGFR mutations.
肺癌是全球发病率和死亡率最高的恶性肿瘤。缺乏有效的检测方法导致传统治疗效果不佳。本研究旨在分析晚期非小细胞肺癌(NSCLC)合并恶性胸腔积液患者胸腔积液表皮生长因子受体(EGFR)突变情况。通过比较EGFR酪氨酸激酶抑制剂(EGFR-TKI)靶向治疗的差异,探索一种新的临床治疗方法。2013年1月至2015年1月,68例确诊为晚期非小细胞肺癌合并恶性胸腔积液的患者纳入本研究。这些患者之前的一线化疗方案均未成功。对所有患者检测EGFR 19和EGFR 21位点。EGFR野生型患者给予铂类药物,作为对照组,接受4个周期治疗,每个周期持续3周。EGFR突变型患者口服TKI药物吉非替尼(易瑞沙™),每日3次,持续4 - 8个月,作为试验组。共有41例EGFR突变患者,其中13例为EGFR 19位点突变,16例为EGFR 21位点突变,其余12例为2个位点突变。EGFR突变在性别、年龄、肿瘤类型、分期和直径方面无显著差异(P>0.05)。结果显示,试验组的6个月生存率、无进展生存期(PFS)、客观缓解率(RP)和疾病控制率(DCR)均高于对照组。试验组的药物副作用与对照组相比无统计学差异(P>0.05)。晚期非小细胞肺癌合并恶性胸腔积液患者的EGFR突变发生率较高。靶向治疗提高了生存率,被认为是EGFR突变患者安全有效的治疗方法。