文章摘要

贝伐单抗联合吉非替尼一线治疗晚期EGFR突变的肺腺癌的临床观察

作者: 1董磊
1 海港医院肿瘤科，河北 秦皇岛 066000
通讯: 董磊 Email: zhongliukedl@163.com
DOI: 10.3978/j.issn.2095-6959.2022.08.003
基金: 秦皇岛市科学技术局项目(201902A113)。

摘要

目的：观察贝伐单抗联合吉非替尼一线治疗晚期表皮生长因子受体(epidermal growth factor receptor，EGFR)突变的肺腺癌的临床疗效。方法：纳入2016年1月至2018年12月海港医院收治的EGFR突变的晚期肺腺癌患者101例，根据治疗方法不同分组，其中采取贝伐单抗联合吉非替尼治疗的52例纳入观察组，仅予以吉非替尼单药治疗的49例纳入对照组。比较两组客观缓解率(objective remission rate，ORR)、无进展生存期(progression-free survival，PFS)、总生存期(overall survival，OS)和生活质量改善情况，比较两组血清癌胚抗原(carcinoembryonic antigen，CEA)、细胞角蛋白19片段(cytokeratin 19 fragment，CYFRA21-1)和糖类抗原125(carbohydrate antigen 125，CA125)水平，并观察两组治疗安全性。结果：观察组ORR为69.23%，高于对照组，差异有统计学意义(P<0.05)。观察组PFS、OS分别为(15.4±4.2)、(24.8±6.9)个月，均高于对照组的(10.3±3.1)、(18.2±5.5)个月，差异有统计学意义(P<0.05)。治疗后，观察组生活质量改善优于对照组(P<0.05)，血清CEA、CYFRA21-1、CA125水平均低于对照组(均P<0.05)。观察组皮肤黏膜损害、肝损害、肾损害等发生率均略高于对照组，但差异无统计学意义(均P>0.05)。结论：贝伐单抗联合吉非替尼一线治疗EGFR突变的晚期肺腺癌疗效优于单药吉非替尼，可有效延长生存期，改善生活质量，且不会明显增加毒副作用。
关键词： 非小细胞肺癌；肺腺癌；EGFR突变；酪氨酸激酶抑制剂；贝伐单抗；生存期；生活质量

Clinical observation of bevacizumab combined with gefitinib in first-line treatment of advanced lung adenocarcinoma with EGFR mutation

Authors: 1DONG Lei
1 Oncology Department, Haigang Hospital, Qinhuangdao Hebei 066000, China

CorrespondingAuthor: DONG Lei Email: zhongliukedl@163.com

DOI: 10.3978/j.issn.2095-6959.2022.08.003

Foundation: This work was supported by the Qinhuangdao Science and Technology Bureau Project, China (201902A113).

Abstract

Objective: To investigate the clinical efficacy of bevacizumab combined with gefitinib in the first-line treatment of advanced epidermal growth factor receptor (EGFR) mutant lung adenocarcinoma. Methods: A total of 101 patients with advanced lung adenocarcinoma with EGFR mutation admitted to Haigang Hospital from January 2016 to December 2018 were enrolled and divided into groups according to different treatment methods. Among them, 52 cases treated with bevacizumab combined with gefitinib were included in the observation group, and 49 cases treated with gefitinib alone were included in the control group. The objective remission rate (ORR), progression-free survival (PFS), overall survival (OS), and quality of life improvement were compared between the 2 groups. The serum levels of carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1) and carbohydrate antigen 125 (CA125) were compared between the 2 groups, and the therapeutic safety of the 2 groups was observed. Results: The ORR rate of the observation group was 69.23%, which was higher than that of the control group, and the difference was statistically significant (P<0.05). The PFS and OS in the observation group were (15.4±4.2) and (24.8±6.9) months, respectively, which were higher than (10.3±3.1) and (18.2±5.5) months in the control group, and the difference was statistically significant (P<0.05). After the treatment, the improvement of quality of life in the observation group was better than that in the control group (P<0.05), and the levels of serum CEA, CYFRA21-1 and CA125 were lower than those in the control group (all P<0.05). The incidences of skin and mucosa damage, liver damage, and kidney damage in the observation group were slightly higher than those in the control group, but the difference was not statistically significant (all P>0.05). Conclusion: The efficacy of bevacizumab combined with gefitinib in the first-line treatment of advanced lung adenocarcinoma with EGFR mutation is better than that of gefitinib alone, which can effectively prolong the survival period and improve the quality of life without significantly increasing the toxic and side effects.

Keywords： non-small cell lung cancer; lung adenocarcinoma; EGFR mutation; tyrosine kinase inhibitor; bevacizumab; survival period; quality of life

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