| 王 一,龚虹云,宋启斌.一线TKI联合放疗对EGFR基因突变的同时性寡转移非小细胞肺癌75例预后的影响分析[J].肿瘤学杂志,2022,28(6):465-471. |
| 一线TKI联合放疗对EGFR基因突变的同时性寡转移非小细胞肺癌75例预后的影响分析 |
| Effect of First-line TKI Combined with Radiotherapy on the Prognosis of 75 Synchronous Oligometastatic EGFR-mutated Non-small Cell Lung Cancer Patients |
| 投稿时间：2022-03-15 |
| DOI：10.11735/j.issn.1671-170X.2022.06.B005 |
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| 中文关键词: 非小细胞肺癌 寡转移 表皮生长因子受体敏感突变 放疗 |
| 英文关键词:non-small cell lung cancer oligometastases epidermal growth factor receptor sensitive mutation radiotherapy |
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| 中文摘要: |
| 摘 要：［目的］ 探讨在接受一线表皮生长因子受体（epidermal growth factor receptor，EGFR）酪氨酸激酶抑制剂（EGFR-TKI）全身治疗的基础上联合放疗能否延长EGFR基因敏感突变的同时性寡转移非小细胞肺癌（non-small cell lung cancer，NSCLC）患者生存期。［方法］ 回顾性分析75例确诊为晚期NSCLC患者的临床资料，寡转移、EGFR基因敏感突变并且接受一线TKI治疗的患者纳入本研究，其中部分患者还接受原发灶和所有转移病灶的放疗。采用Kaplan-Meier法评估其无进展生存期（progression-free survival，PFS）和总生存期（overall survival，OS）。［结果］ 75例患者中32例（42.7%）接受了全部病灶的放疗（放疗组），43例（57.3%）未接受放疗（未放疗组）。放疗组的PFS优于未放疗组（中位PFS：19.0个月 vs 13.0个月，P<0.001），放疗组的OS也优于未放疗组（中位OS：35.0个月 vs 26.0个月，P=0.009）。Cox多因素回归分析显示转移灶数目不超过2个、对原发及转移灶进行放疗为PFS和OS的独立预后因素。放疗引起的3级及以上不良反应包括放射性肺炎（6.3%）和放射性食管炎（12.5%）。［结论］ 对于EGFR基因敏感突变的同时性寡转移NSCLC患者，在TKI一线治疗的基础上对所有病灶进行放疗是一种可行的选择，与未放疗的患者相比，可显著延长PFS和OS。 |
| 英文摘要: |
| Abstract： ［Objective］ To investigate whether radiotherapy combined with first-line EGFR tyrosine kinase inhibitor(EGFR-TKI) can improve the survival of patients with synchronous oligometastatic non-small cell lung cancer(NSCLC). ［Methods］ The clinical data of 75 patients with advanced NSCLC were retrospectively analyzed. Patients with synchronous oligometastases and EGFR sensitive mutation that received first-line EGFR-TKI were included in this study. Part of them received radiotherapy for primary and all metastatic lesions. Progression-free survival(PFS) and overall survival(OS) were evaluated by Kaplan-Meier curves. ［Results］ Of the 75 patients， 32(42.7%) received radiotherapy for all residual lesions(RT group)， and 43(57.3%) did not receive any radiotherapy(non-RT group). The PFS in the RT group was significantly better than that in the non-RT group(median PFS： 19.0 months vs 13.0 months， P<0.001). The OS in the RT group was also better than that in the non-RT group(median OS： 35.0 months vs 26.0 months， P=0.009). The results of the Cox multivariate regression analysis revealed that the number of metastatic lesions(≤2) and radiotherapy for primary and all metastatic lesions were independent prognostic factors for PFS and OS. Adverse events(grade≥3) caused by radiotherapy included pneumonia(6.3%) and esophagitis(12.5%). ［Conclusion］ For synchronous oligometastatic NSCLC with EGFR sensitive mutation， radiotherapy for primary and all metastatic lesions on the basis of first-line TKI is a feasible choice， which can significantly improve PFS and OS compared with patients without radiotherapy. |
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