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射频消融联合表皮生长因子受体酪氨酸激酶抑制剂治疗表皮生长因子受体突变非小细胞肺癌的临床价值 被引量:9

Radiofrequency ablation combined with EGFR-TKIs for EGFR mutant non-small cell lung cancer:its clinical application
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摘要 目的回顾性分析射频消融(RFA)联合表皮生长因子受体酪氨酸激酶抑制剂(EGFRTKIs)治疗EGFR突变非小细胞肺癌(NSCLC)的临床结果。方法 2009年6月—2016年9月收治的67例NSCLC患者接受RFA联合EGFR-TKIs治疗,观察其安全性及疗效。其中右肺42例,左肺25例;Ⅰ期5例,Ⅱ期2例,Ⅲ期11例,Ⅳ期49例。结果所有患者无围术期死亡。平均随访21.9个月。局部进展率为19.4%(13/67),局部进展时间平均18.1个月。平均肿瘤无进展时间(PFS)为(34.0±5.0)(95%CI:24.2~43.8)个月,平均总生存时间(OS)为(36.0±4.2)(95%CI:27.8~44.3)个月。RFA联合不同EGFR-TKIs治疗NSCLC的平均PFS分别为(36.1±6.5)(95%CI:23.3~48.9)个月、(17.0±3.4)(95%CI:10.3~23.7)个月和(29.3±4.5)(95%CI:20.5~38.1)个月(P>0.05);平均OS分别为(40.2±5.7)(95%CI:29.1~51.3)个月、(17.0±3.2)(95%CI:10.7~23.4)个月和(36.0±4.2)(95%CI:27.8~44.3)个月(P>0.05)。结论针对EGFR敏感突变的NSCLC患者,RFA联合EGFR-TKIs可提高局部控制率,并延长肿瘤无进展生存期和总生存期。 Objective To retrospectively analyze the clinical efficacy of radiofrequency ablation(RFA) combined with epidermal growth factor receptor tyrosine kinase inhibitors(EGFR-TKIs) in treating EGFR mutant non-small cell lung cancer(NSCLC). Methods From June 2009 to September 2016, a total of 67 NSCLC patients were treated with RFA combined with EGFR-TKIs therapy. The safety and therapeutic effect of the therapy were evaluated. The lesions were located in right lung(n=42) or left lung(n=25). Stage I NSCLC was seen in 5 patients, stage II NSCLC in 2 patients, Stage Ⅲ NSCLC in 11 patients, and stage ⅣNSCLC in 49 patients. Results No perioperative death occurred. The average follow-up time was 21.9 months. The local progression rate was 19.4%(13/67), and the local progression time was 18.1 months. The average progression-free survival(PFS) was(34.0±5.0) months(95%CI:24.2-43.8 months), and the average overall survival(OS) was(36.0±4.2) months(95%CI:27.8-44.3 months). According to the use of different EGFR-TKIs after RFA, the patients were divided into gefitinib group, erlotinib group and icotinib group. In gefitinib group, erlotinib group and icotinib group, the mean PFS was(36.1±6.5) months(95%CI:23.3-48.9 months),(17.0±3.4) months(95%CI:10.3-23.7 months) and(29.3±4.5) months(95%CI:20.5-38.1 months)respectively(P〉0.05), and the mean OS was(40.2±5.7) months(95%CI:29.1-51.3 months),(17.0±3.2)months(95%CI:10.7-23.4 months) and(36.0±4.2) months(95%CI:27.8-44.3 months) respectively(P〉0.05). Conclusion For the treatment of EGFR mutant NSCLC, RFA combined with EGFR-TKIs therapy can improve the local control rate and prolong both PFS and OS.
作者 刘宝东 胡牧 刘磊 钱坤 李元博 LIU Baodong;HU Mu;LIU Lei;QIAN Kun;LI Yuanbo(Department of Thoracic Surgery,Xuanwu Hospital of Capital Medical University,Beijing 100053,China)
出处 《介入放射学杂志》 CSCD 北大核心 2018年第11期1036-1039,共4页 Journal of Interventional Radiology
关键词 射频消融 表皮生长因子受体酪氨酸激酶抑制剂 非小细胞肺癌 radiofrequency ablation epidermal growth factor receptor tyrosine kinase inhibitor nonsmall cell lung cancer
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