埃克替尼在老年晚期非小细胞肺癌病人中的疗效及安全性研究

doi:10.3969/j.issn.1003-9198.2021.06.020

摘要/Abstract

摘要： 目的观察盐酸埃克替尼在晚期老年非小细胞肺癌(NSCLC)病人中的疗效及安全性,并分析影响其疗效的相关因素。方法回顾性分析2015年1月至2020年2月期间收治的41例晚期NSCLC病人,年龄>60岁,口服盐酸埃克替尼125 mg,3次/d,观察病人接受该药物治疗的疗效、不良反应及无进展生存期(PFS)。结果可评价疗效的41例晚期NSCLC病人的客观有效率 (ORR)为53.7％,疾病控制率(DCR)为80.5％,全组病人中位PFS为10.83个月(95%CI: 7.40~14.23个月)。全组病人中28例病人表皮生长因子受体(EGFR)基因突变阳性,EGFR突变阳性病人的ORR为67.9％(19／28),DCR为92.9％(26／28),均显著优于EGFR野生型(P<0.05)病人。体力状态(PS)评分0~1分的病人的ORR和DCR均显著高于PS评分2~3分的病人(P<0.05)。单因素分析显示,EGFR突变状态、PS评分与PFS存在相关性(P<0.05);多因素分析显示,PS评分是影响晚期NSCLC病人PFS的独立因素。药物常见不良反应主要为皮疹、腹泻、乏力,绝大多数为Ⅰ~Ⅱ度,经对症处理后多可缓解,只有2例病人因严重肝损伤暂时减停药物。结论盐酸埃克替尼治疗老年晚期NSCLC的疗效肯定,不良反应轻微,尤其在PS评分良好及EGFR阳性的病人中。

关键词: 晚期非小细胞肺癌, 埃克替尼, 老年人, 表皮生长因子受体, 不良反应

Abstract: Objective To observe the efficacy and safety of icotinib in the elderly patients with advanced non-small cell lung cancer (NSCLC). Methods A total of 41 advanced NSCLC patients aged >60 years old were retrospectively analyzed from January 2015 to February 2020. Results The clinical data of 41 elderly patients including 28 cases of epidermal growth factor receptor(EGFR) mutation and 13 cases of wild type with advanced NSCLC were enrolled in this study. The patients’ overall objective response rate (ORR) was 53.7% and the disease control rate (DCR) was 80.5%; In the patients with EGFR mutation, ORR was 67.9%, DCR was 92.9%, which were significantly higher than those in the patients with EGFR gene wild type. Single factor analysis showed that EGFR mutation and performance status (PS) score were related with PFS (P<0.05), and multiple Cox regression analysis showed that PS score was the independent influencing factor of the prognosis. The most common adverse events were rash, diarrhea and fatigue. Only 2 patients discontinued the medication due to severe liver injury. Conclusions Icotinib is a safe and effective targeted therapy in the elderly patients with advanced NSCLC, especially in the patients with better PS scores and EGFR mutation.

Key words: non-small cell lung cancer, icotinib, aged, epidermal growth factor receptor, toxicity

中图分类号:

R 734.2

徐伟, 方乐平, 刘苏瑶, 王琳, 许菊青, 杨舒, 王峻, 樊卫飞. 埃克替尼在老年晚期非小细胞肺癌病人中的疗效及安全性研究[J]. 实用老年医学, 2021, 35(6): 612-615.

XU Wei, FANG Le-ping, LIU Su-yao, WANG Lin, XU Ju-qing, YANG Shu, WANG Jun, FAN Wei-fei. Efficacy and safety of icotinib in the elderly patients with advanced non-small cell lung cancer[J]. Practical Geriatrics, 2021, 35(6): 612-615.

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