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目的:探讨厄洛替尼与紫杉醇联合卡铂化疗治疗表皮生长因子受体(EGFR)突变的老年非小细胞肺癌(NSCLC)患者的临床疗效和安全性。方法:选取2011年1月-2012年6月住院治疗的老年NSCLC患者共90例,按照2∶1的病例随机化分为2组。厄洛替尼组60例,150 mg/次,qd,服用直至出现严重不良反应;对照组30例,紫杉醇175 mg·m-2静滴,d1,卡铂按AUC5计算药量,静滴,每21天为1周期,共4周期后定期复查。结果:厄洛替尼组有效率和疾病控制率分别为81.0%(47/58)和89.7%(52/58),明显高于对照组34.5%(10/29)和62.1%(18/29),差异均有统计学意义(P<0.05)。厄洛替尼组中位无进展生存期为12.1个月(95%CI:10.32~13.01个月),明显高于对照组6.2个月(95%CI:3.18~8.01个月),差异有统计学意义(P<0.05);但两组中位生存期分别为19.3个月(95%CI:16.51~22.31个月)和17.2个月(95%CI:14.56~18.64个月),差异无统计学意义(P>0.05)。2组药物不良发应多为1和2级,未出现不能耐受者或者药物相关死亡病例。对照组发生CTC3~4级发生率为60.0%(18/30)明显高于厄洛替尼组11.7%(7/60),差异有统计学意义(χ2=23.289,P=0.000)。结论:厄洛替尼能提高EGFR突变老年NSCLC患者的治疗有效率、疾病控制率,中位无进展生存期明显较长,不良反应发生率低、症状轻,可以考虑作为EGFR突变老年NSCLC患者治疗的替代药物。
Objective: To investigate the clinical efficacy and safety of erlotinib and paclitaxel combined with carboplatin in the treatment of epidermal growth factor receptor (EGFR) mutations in elderly patients with non-small cell lung cancer (NSCLC). Methods: A total of 90 elderly NSCLC patients admitted to hospital from January 2011 to June 2012 were randomly divided into 2 groups according to a 2: 1 case. 60 cases of erlotinib group, 150 mg / time, qd, taking until serious adverse reactions; control group of 30 patients, paclitaxel 175 mg · m-2 intravenous drip, d1, carboplatin calculated by AUC5 dose intravenous infusion, Every 21 days for a cycle, a total of 4 cycles after a regular review. Results: The efficacy and disease control rates in the erlotinib group were 81.0% (47/58) and 89.7% (52/58), respectively, which were significantly higher than those in the control group 34.5% (10/29) and 62.1% (18/29) ), The differences were statistically significant (P <0.05). The median progression-free survival of the erlotinib group was 12.1 months (95% CI: 10.32 to 13.01 months), significantly higher than that of the control group for 6.2 months (95% CI: 3.18 to 8.01 months) (95% CI: 16.51-22.31 months) and 17.2 months (95% CI: 14.56-18.64 months), respectively, with no significant difference between the two groups Significance (P> 0.05). Two groups of adverse drug reactions were mostly 1 and 2, no unbearable or drug-related deaths. The incidence of CTC grade 3 to 4 in the control group was 60.0% (18/30), which was significantly higher than that in the erlotinib group (11.7%, 7/60). The difference was statistically significant (χ2 = 23.289, P = 0.000). CONCLUSION: Erlotinib can improve the treatment efficiency, the disease control rate, the median progression-free survival time, the low incidence of adverse reactions and the mild symptoms in elderly NSCLC patients with EGFR mutation. It may be considered as an EGFR mutation in the treatment of elderly NSCLC patients Alternative medicine.