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表皮生长因子受体突变的大型非小细胞肺癌患者接受吉非替尼联合或不联合经动脉灌注化疗(顺铂)的效果。

Gefitinib with or without Transarterial Infusion Chemotherapy (Cisplatin) for Large Nonsmall Cell Lung Cancer with Epidermal Growth Factor Receptor Mutations.

机构信息

Department of Radiology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China; Department of Interventional Oncology, The First Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.

State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, China.

出版信息

J Vasc Interv Radiol. 2019 Jul;30(7):1004-1012. doi: 10.1016/j.jvir.2018.12.705. Epub 2019 Jun 4.

Abstract

PURPOSE

To retrospectively investigate the safety and benefit of gefitinib plus transarterial infusion (TAI) therapy as a first-line treatment compared to gefitinib alone for patients with large (>7 cm) nonsmall cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutations.

MATERIALS AND METHODS

Between January 2010 and December 2013, 92 consecutive treatment-naïve patients with large NSCLC with EGFR mutations, who were treated using gefitinib plus TAI (G+T, n = 42) or gefitinib alone (G, n = 50) were reviewed. The primary endpoints were the objective response rate (ORR) and tumor reduction rate. The secondary endpoints were progression-free survival (PFS) and overall survival (OS), and safety was also assessed.

RESULTS

The baseline characteristics of the 2 groups were balanced, and no patients experienced treatment-related death. Toxicity outcomes did not differ between the G+T and G groups. The tumor reduction rate in the G+T group was significantly higher than that in the G group (42.9 vs 31.9%, P = .028). The ORR was 83% in the G+T group and 72% in the G group (P = .197). The median PFS was significantly longer in the G+T group than in the G group (14.0 vs 10.0 months, P = .023). The median OS was 30.0 months in the G+T group and 27.0 months in the G group (P = .235).

CONCLUSIONS

This study suggests that compared with gefitinib alone, combination therapy with gefitinib plus TAI was well tolerated and potentially improved the tumor reduction rate and PFS in patients with large NSCLC with EGFR mutations.

摘要

目的

回顾性研究表皮生长因子受体(EGFR)突变的大型(>7 cm)非小细胞肺癌(NSCLC)患者一线使用吉非替尼联合肝动脉灌注化疗(TAI)与吉非替尼单药治疗的安全性和获益。

材料与方法

2010 年 1 月至 2013 年 12 月,92 例初治的 EGFR 突变的大型 NSCLC 患者,分别接受吉非替尼联合 TAI(G+T,n=42)或吉非替尼单药(G,n=50)治疗。主要终点为客观缓解率(ORR)和肿瘤退缩率。次要终点为无进展生存期(PFS)和总生存期(OS),并评估安全性。

结果

两组患者的基线特征平衡,无治疗相关死亡。G+T 组和 G 组的毒性反应结果无差异。G+T 组的肿瘤退缩率显著高于 G 组(42.9% vs 31.9%,P=0.028)。G+T 组的 ORR 为 83%,G 组为 72%(P=0.197)。G+T 组的中位 PFS 显著长于 G 组(14.0 个月 vs 10.0 个月,P=0.023)。G+T 组的中位 OS 为 30.0 个月,G 组为 27.0 个月(P=0.235)。

结论

与吉非替尼单药治疗相比,吉非替尼联合 TAI 治疗具有良好的耐受性,并可能提高 EGFR 突变的大型 NSCLC 患者的肿瘤退缩率和 PFS。

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