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晚期非小细胞肺癌:对微波消融的反应及表皮生长因子受体状态

Advanced non small cell lung cancer: response to microwave ablation and EGFR Status.

作者信息

Wei Zhigang, Ye Xin, Yang Xia, Huang Guanghui, Li Wenhong, Wang Jiao, Han Xiaoying, Meng Min, Ni Yang

机构信息

Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwuweiqi Road, Jinan, Shandong Province, China, 250021.

出版信息

Eur Radiol. 2017 Apr;27(4):1685-1694. doi: 10.1007/s00330-016-4474-4. Epub 2016 Jul 19.

Abstract

OBJECTIVES

To verify the association between EGFR status and clinical response to microwave ablation (MWA) and survival.

METHODS

NSCLC patients with known EGFR status and treated with MWA in combination with chemotherapy were retrospectively enrolled in the study.

RESULTS

A total of 61 patients were recruited. EGFR mutations were found in 28 patients (39.4 %), and were more common in women (67.7 %) and nonsmokers (74.1 %). Complete ablation was achieved in 69.7 % of patients with EGFR mutant tumours and in 82.1 % of patients with EGFR wild-type tumours (p = 0.216). The median progression-free survival (PFS) and overall survival (OS) were 8.3 months and 27.2 months in patients with an EGFR mutant tumour. The corresponding values were 5.4 months (p = 0.162) and 17.8 months (p = 0.209) in patients with an EGFR wild-type tumour. Patients with complete ablation had longer PFS (7.8 months vs. 4.2 months, p = 0.024) and OS (28.1 months vs. 12.6 months, p = 0.001) than those with incomplete ablation. Multivariate analyses also showed that response to MWA was an independent prognostic factor for OS, but EGFR status was not, and that neither response to MWA nor EGFR status was a prognostic factor for PFS.

CONCLUSIONS

The EGFR status was not related to response to MWA, and response to MWA was a predictor of survival.

KEY POINTS

• EGFR mutations were commonly seen in women and in nonsmokers • EGFR status had no correlation with the response to MWA, PFS and OS. • The response to MWA could predict PFS and OS.

摘要

目的

验证表皮生长因子受体(EGFR)状态与微波消融(MWA)临床反应及生存率之间的关联。

方法

回顾性纳入已知EGFR状态并接受MWA联合化疗的非小细胞肺癌(NSCLC)患者。

结果

共招募61例患者。28例(39.4%)患者检测到EGFR突变,在女性(67.7%)和非吸烟者(74.1%)中更常见。EGFR突变型肿瘤患者69.7%实现完全消融,EGFR野生型肿瘤患者为82.1%(p = 0.216)。EGFR突变型肿瘤患者的无进展生存期(PFS)和总生存期(OS)中位数分别为8.3个月和27.2个月。EGFR野生型肿瘤患者相应数值分别为5.4个月(p = 0.162)和17.8个月(p = 0.209)。完全消融患者的PFS(7.8个月对4.2个月,p = 0.024)和OS(2个月对12.6个月,p = 0.001)长于未完全消融患者。多因素分析还显示,MWA反应是OS的独立预后因素,但EGFR状态不是,且MWA反应和EGFR状态均不是PFS的预后因素。

结论

EGFR状态与MWA反应无关,MWA反应是生存率的预测指标。

要点

• EGFR突变在女性和非吸烟者中常见 • EGFR状态与MWA反应、PFS和OS无相关性。 • MWA反应可预测PFS和OS。

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