Zhao Xiao, Zhu Guangqin, Chen Huoming, Yang Ping, Li Fang, Du Nan
Department of Medical Oncology, Affiliated Hospital of PLA General Hospital, Beijing, China.
General Hospital of the Air Force of People's Liberation Army, Beijing, China.
J Cancer Res Ther. 2016 Jul-Sep;12(3):1127-1131. doi: 10.4103/0973-1482.194599.
This study aimed to investigate the potential use of icotinib as first-line treatment to prevent brain metastasis from advanced lung adenocarcinoma.
This investigation was designed as a retrospective nonrandomized controlled study. Enrolled patients received either icotinib or traditional chemotherapy as their first-line treatment. The therapeutic efficacy was compared among patients with advanced. (stages IIIB and IV) lung adenocarcinoma with epidermal growth factor receptor (EGFR)-sensitive mutation. The primary endpoint was the cumulative incidence of brain metastasis, whereas, the secondary endpoint was overall survival(OS). Death without brain metastasis was considered a competitive risk to calculate the cumulative risk of brain metastasis. Survival analysis was conducted using the Kaplan-Meier method and statistical significance was determined using the log-rank test.
The present study included 396 patients with 131 in the icotinib group and 265 in the chemotherapy group. Among those with EGFR-sensitive mutation, the cumulative risk of brain metastasis was lower in the icotinib group than in the chemotherapy group. However, no significant difference in OS was observed between the two groups.
Icotinib can effectively reduce the incidence of brain metastasis and therefore improve prognosis in advanced lung adenocarcinoma patients with EGFR.sensitive mutation.
本研究旨在探讨埃克替尼作为一线治疗预防晚期肺腺癌脑转移的潜在用途。
本研究设计为回顾性非随机对照研究。入组患者接受埃克替尼或传统化疗作为一线治疗。对表皮生长因子受体（EGFR）敏感突变的晚期（ⅢB期和Ⅳ期）肺腺癌患者的治疗效果进行比较。主要终点是脑转移的累积发生率，次要终点是总生存期（OS）。无脑转移死亡被视为计算脑转移累积风险的竞争风险。采用Kaplan-Meier法进行生存分析，采用对数秩检验确定统计学意义。
本研究纳入396例患者，埃克替尼组131例，化疗组265例。在EGFR敏感突变患者中，埃克替尼组脑转移的累积风险低于化疗组。然而，两组之间的总生存期未观察到显著差异。
埃克替尼可有效降低脑转移发生率，从而改善EGFR敏感突变的晚期肺腺癌患者的预后。
