张崇国 王继荣 李娟 王科明 王朝霞 李亚东

    [摘要] 目的 对比分析非小细胞肺癌患者接受表皮生长因子受体-酪氨酸激酶抑制剂(EGFR-TKIs)和化疗交替治疗与单纯化疗的总生存率。 方法 回顾性分析2010年1月～2014年12月收治的58例EGFR基因状态不明、经组织病理学证实的晚期非小细胞肺癌患者的临床资料。其中，36例患者采用EGFR-TKIs和化疗交替治疗(交替治疗组)，22例患者采用单纯化疗(单纯化疗组)。采用Log-rank检验组间生存差异，Kaplan-Meier法进行生存分析，Cox比例风险模型进行单因素和多因素分析。 结果 交替治疗组患者平均生存时间为[42.740(*)±3.668]个月，中位生存时间为36个月；单纯化疗组平均生存时间为[30.444(*)±5.122]个月，中位生存时间为28个月；经Log-rank检验，交替治疗组患者预后好于单纯化疗组(P=0.0413)；Cox回归分析得出接受治疗的方法是影响肺癌预后的独立因素(P=0.047、0.008)，而吸烟状况、病理类型、年龄、性别等对预后没有影响(P > 0.05)。 结论 EGFR-TKI和化疗交替进行能有效延长EGFR突变状态不明的NSCLC患者生存。

    [关键词] 非小细胞肺癌；表皮生长因子受体-酪氨酸激酶抑制剂；化疗

    [中图分类号] R734.2 [文献标识码] A [文章编号] 1673-7210(2018)02(b)-0107-06

    [Abstract] Objective To compare and analyze the overall survival (OS) of patients with advanced non-small-cell lung cancer and EGFR mutated-unknown after the treatment of EGFR-TKI and intercalated combination of chemotherapy and EGFR-TKI. Methods Clinical data of 58 patients with advanced histopathology confirmed non-small-cell lung cancer and EGFR mutated-unknown treated in the Second Affiliated Hospital of Nanjing Medical University from January 2010 to December 2014 was analyzed retrospectively. 36 patients were treated with intercalated combination of chemotherapy and EGFR-TKIs (rotational therapy group) and 22 patients were treated with chemotherapy alone (chemotherapy group). The survival rate was calculated by Kaplan-Meier method and compared by Log-rank test. Cox single and multivariate prognosis analysis was performed. Results 22 patients received chemotherapy ......