一线酪氨酸激酶抑制剂在不可切除的 IIIB 期和 IV 期 EGFR 突变型非小细胞肺癌患者中的疗效。

Efficacy of first-line tyrosine kinase inhibitor between unresectable stage III and stage IV EGFR-mutated non-small cell lung cancer patients.

机构信息

Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning 530021, Guangxi, P.R. China.

出版信息

Aging (Albany NY). 2023 Jun 8;15(11):5066-5074. doi: 10.18632/aging.204781.

PURPOSE

To compare survivals between unresectable stage III and stage IV EGFR-mutated non-small cell lung cancer (NSCLC) patients receiving first-line EGFR-TKI.

MATERIALS AND METHODS

Unresectable stage III and stage IV EGFR-mutated NSCLC patients were investigated from September 2012 to May 2022. Patients received EGFR-TKI as the first-line treatment. Progression-free survival (PFS) and overall survival (OS) were assessed using the Kaplan-Meier method and propensity score matching (PSM) analyses.

RESULTS

A total of 558 patients were included: 478 (85.66%) patients were stage IV and 80 (14.34%) patients were stage III. Before PSM, stage III patients showed a better median PFS (15 vs. 13 months; =0.026) and a similar median OS (29 vs. 30 months; =0.820) compared to stage IV patients. Stage IV was an independent prognostic factor for PFS [hazard ratio (HR)=1.47, 95% confidence interval (CI): 1.06-2.04; =0.021], but not for OS (HR=1.11, 95% CI: 0.77-1.60; =0.560). After PSM, a better median PFS (15 vs. 12 months; =0.016) and a similar median OS (29 vs. 30 months; =0.960) were found between stage III and stage IV patients.

CONCLUSIONS

OS was similar between unresectable stage III and stage IV EGFR-mutated NSCLC patients receiving EGFR-TKI as the first-line treatment.

目的

比较接受一线 EGFR-TKI 治疗的不可切除 III 期和 IV 期 EGFR 突变型非小细胞肺癌（NSCLC）患者的生存情况。

材料与方法

本研究纳入了 2012 年 9 月至 2022 年 5 月期间的不可切除 III 期和 IV 期 EGFR 突变型 NSCLC 患者。患者接受 EGFR-TKI 作为一线治疗。采用 Kaplan-Meier 法和倾向评分匹配（PSM）分析评估无进展生存期（PFS）和总生存期（OS）。

结果

共纳入 558 例患者：478 例（85.66%）为 IV 期，80 例（14.34%）为 III 期。在 PSM 之前，III 期患者的中位 PFS（15 个月 vs. 13 个月；=0.026）和中位 OS（29 个月 vs. 30 个月；=0.820）均优于 IV 期患者。IV 期是 PFS 的独立预后因素[风险比（HR）=1.47，95%置信区间（CI）：1.06-2.04；=0.021]，但不是 OS 的独立预后因素（HR=1.11，95%CI：0.77-1.60；=0.560）。PSM 后，III 期和 IV 期患者的中位 PFS（15 个月 vs. 12 个月；=0.016）和中位 OS（29 个月 vs. 30 个月；=0.960）仍存在差异。