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局部巩固治疗比单独使用表皮生长因子受体酪氨酸激酶抑制剂在骨寡转移肺腺癌患者中有生存获益。

Additional local consolidative therapy has survival benefit over EGFR tyrosine kinase inhibitors alone in bone oligometastatic lung adenocarcinoma patients.

机构信息

Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, PR China.

Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, PR China.

出版信息

Lung Cancer. 2019 Sep;135:138-144. doi: 10.1016/j.lungcan.2019.07.024. Epub 2019 Jul 24.

Abstract

OBJECTIVES

Whether epidermal growth factor receptor tyrosine-kinase inhibitors (EGFR-TKIs) plus local consolidative therapy (LCT) has survival benefit over EGFR-TKIs alone in lung adenocarcinoma patients with EGFR mutation and bone oligometastases remains controversial.

MATERIALS AND METHODS

We conducted a retrospective study to assess the effects of LCT in lung adenocarcinoma patients with bone oligometastases and EGFR mutation. The primary endpoint was overall survival (OS); the secondary endpoints was progression-free survival (PFS).

RESULTS

A total of 127 lung adenocarcinoma patients with EGFR mutation and bone oligometastases were assessed, including 65 patients received EGFR-TKIs alone (monotherapy group) and 62 patients received EGFR-TKIs plus local consolidative therapy (LCT) (combination group). Addition of LCT was associated with significantly longer OS (36.3 vs. 21.0 months, P = 0.01; hazard ratio [HR] = 0.537, 95% confidence interval [CI]: 0.360-0.801, p = 0.01) and PFS (14.0 vs. 8.1 months, P = 0.01; HR = 0.613, 95%CI: 0.427-0.879, p = 0.01) in the whole cohort.

CONCLUSION

In lung adenocarcinoma patients with EGFR-mutation and bone oligometastases, LCT plus EGFR-TKIs therapy is associated with significantly longer OS and PFS compared with EGFR-TKIs therapy alone, indicating that LCT plus EGFR-TKIs therapy might be a better therapeutic option for this patient population.

摘要

目的

表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs)联合局部巩固治疗(LCT)是否比单独使用 EGFR-TKIs 对伴有 EGFR 突变和骨寡转移的肺腺癌患者具有生存优势仍存在争议。

材料与方法

我们进行了一项回顾性研究,以评估 LCT 在伴有骨寡转移和 EGFR 突变的肺腺癌患者中的作用。主要终点是总生存期(OS);次要终点是无进展生存期(PFS)。

结果

共评估了 127 例伴有 EGFR 突变和骨寡转移的肺腺癌患者,其中 65 例患者接受 EGFR-TKIs 单独治疗(单药组),62 例患者接受 EGFR-TKIs 联合局部巩固治疗(联合组)。联合 LCT 治疗与显著延长 OS(36.3 个月 vs. 21.0 个月,P=0.01;风险比 [HR] =0.537,95%置信区间 [CI]:0.360-0.801,P=0.01)和 PFS(14.0 个月 vs. 8.1 个月,P=0.01;HR=0.613,95%CI:0.427-0.879,P=0.01)有关。

结论

在伴有 EGFR 突变和骨寡转移的肺腺癌患者中,与单独使用 EGFR-TKIs 相比,LCT 联合 EGFR-TKIs 治疗可显著延长 OS 和 PFS,这表明 LCT 联合 EGFR-TKIs 治疗可能是该患者人群的更好治疗选择。

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