Wei Zhigang, Ye Xin, Yang Xia, Zheng Aimin, Huang Guanghui, Li Wenhong, Wang Jiao, Han Xiaoying, Meng Min, Ni Yang
Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China.
Oncotarget. 2017 May 23;8(34):56714-56725. doi: 10.18632/oncotarget.18083. eCollection 2017 Aug 22.
We conducted this retrospective study to investigate whether microwave ablation (MWA) of primary tumor sites plus epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) could improve survival in advanced non small cell lung cancer (NSCLC) with EGFR mutations. MWA was conducted at the primary tumor sites, followed by EGFR-TKIs in the MWA plus EGFR-TKIs group. EGFR-TKIs were administered until disease progression or intolerable toxicity. The primary endpoint was progression-free survival (PFS); secondary endpoints were overall survival (OS) and objective response rate (ORR). A total of 58 patients were recruited, including 34 in the MWA plus EGFR-TKIs group and 24 in the EGFR-TKIs group. No significant difference in ORR was observed with MWA treatment (61.8% vs. 45.8%, p = 0.230). Patients treated with MWA plus EGFR-TKIs failed to show superior survival in either PFS (13.2 months vs. 11.6 months, p = 0.640) or OS (39.8 months vs. 20.4 months, p = 0.288). MWA was not an independent prognostic factor for PFS or OS. MWA of primary tumor sites plus EGFR-TKIs demonstrated no survival advantage compared with EGFR-TKIs alone in advanced NSCLC patients with EGFR sensitive mutations. MWA should not be recommended for unselected patients with EGFR-sensitive mutations.
我们开展了这项回顾性研究,以调查对原发性肿瘤部位进行微波消融(MWA)联合表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs)是否能改善表皮生长因子受体(EGFR)突变的晚期非小细胞肺癌(NSCLC)患者的生存期。在原发性肿瘤部位进行MWA,之后MWA联合EGFR-TKIs组接受EGFR-TKIs治疗。持续给予EGFR-TKIs直至疾病进展或出现不可耐受的毒性。主要终点为无进展生存期(PFS);次要终点为总生存期(OS)和客观缓解率(ORR)。共招募了58例患者,其中MWA联合EGFR-TKIs组34例,EGFR-TKIs组24例。MWA治疗的ORR未观察到显著差异(61.8%对45.8%,p = 0.230)。接受MWA联合EGFR-TKIs治疗的患者在PFS(13.2个月对11.6个月,p = 0.640)或OS(39.8个月对20.4个月,p = 0.288)方面均未显示出更好的生存期。MWA不是PFS或OS的独立预后因素。对于EGFR敏感突变的晚期NSCLC患者,原发性肿瘤部位MWA联合EGFR-TKIs与单纯EGFR-TKIs相比未显示出生存优势。对于未筛选的EGFR敏感突变患者,不应推荐MWA治疗。