Department of Respiratory Medicine, Kumamoto Regional Medical Center, Kumamoto, Japan
Department of Respiratory Medicine, Kumamoto Regional Medical Center, Kumamoto, Japan.
Anticancer Res. 2020 Feb;40(2):1117-1121. doi: 10.21873/anticanres.14051.
BACKGROUND/AIM: The survival benefit of first-line epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) therapy without pleurodesis in EGFR-mutant lung adenocarcinoma patients with malignant pleural effusions (MPE) remains unclear.
We retrospectively evaluated overall survival (OS) among EGFR wild-type lung adenocarcinoma patients with MPE who received chemotherapy with pleurodesis (CT+PLD) and without pleurodesis (CT-PLD), and EGFR-mutant lung adenocarcinoma patients with MPE who received EGFR-TKI therapy with pleurodesis (TKI+PLD) and without pleurodesis (TKI-PLD).
There was no difference in OS between the CT+PLD and the CT-PLD groups (10.8 months vs. 7.4 months). As compared to the TKI+PLD group, OS tended to be longer in the TKI-PLD group (21.8 months vs. 31.1 months). Patients in the TKI-PLD group had no hypoalbuminemia or deterioration of performance status during management of MPE and could receive second- and further-line therapy.
EGFR-mutant patients with MPE who received first-line EGFR-TKI therapy without pleurodesis may show a better prognosis than those with pleurodesis.
背景/目的：在伴有恶性胸腔积液（MPE）的表皮生长因子受体突变型肺腺癌患者中，一线表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKI）治疗而不进行胸膜固定术是否具有生存获益仍不清楚。
我们回顾性评估了接受有胸膜固定术（CT+PLD）和无胸膜固定术（CT-PLD）化疗的 EGFR 野生型肺腺癌伴 MPE 患者、以及接受有胸膜固定术（TKI+PLD）和无胸膜固定术（TKI-PLD）EGFR-TKI 治疗的 EGFR 突变型肺腺癌伴 MPE 患者的总生存期（OS）。
CT+PLD 组与 CT-PLD 组的 OS 无差异（10.8 个月 vs. 7.4 个月）。与 TKI+PLD 组相比，TKI-PLD 组的 OS 倾向于更长（21.8 个月 vs. 31.1 个月）。在 MPE 管理过程中，TKI-PLD 组的患者没有低白蛋白血症或体能状态恶化，并且可以接受二线和进一步的治疗。
接受一线 EGFR-TKI 治疗而不进行胸膜固定术的伴有 MPE 的 EGFR 突变型患者可能比进行胸膜固定术的患者具有更好的预后。
