埃克替尼治疗非小细胞肺癌脑转移的临床疗效观察

    Clinical observation of icotinib in the treatment of advanced non-small cell lung cancer with brain metastases

    • 摘要: 目的:分析埃克替尼治疗非小细胞肺癌(NSCLC)脑转移的疗效和安全性。方法:对26例NSCLC脑转移病人的临床资料进行回顾性分析。所有病人均服用埃克替尼125mg,每天3次,直至病情进展、死亡或出现不可耐受的不良反应。结果:26例病人颅内病变有效率(ORR)和疾病控制率(DCR)分别为7.7%和84.6%,全身病变ORR和DCR分别为11.5%和76.9%。总体DCR与病人的年龄、性别、吸烟状况、PS评分、病理类型、表皮生长因子受体(EGFR)突变状态、埃克替尼治疗时机、脑转移灶数目(单发或多发)、脑部放疗及化疗与否等临床特征均未见相关性(P>0.05)。全组中位无进展生存时间(PFS)和中位生存时间(OS)分别为4.0个月(95%CI 2.4~5.6个月)和8.3个月(95%CI 4.9~11.7个月)。PFS与病人体力活动状态(PS)评分、EGFR突变状态具有相关性(P<0.01和P<0.05),OS与病人的年龄、PS评分、病理类型、EGFR状态、化疗与否具有相关性(P<0.05~P<0.01)。不良反应可耐受,主要表现为轻度皮疹、腹泻等。结论:埃克替尼治疗NSCLC脑转移具有一定疗效,且安全性好,可作为脑转移病人个体化治疗策略之一。

       

      Abstract: Objective:To analyze of the efficacy and safety of icotinib in the treatment of brain metastases from non-small cell lung cancer(NSCLC).Methods:The clinical data of 26 NSCLC patients with brain metastases treated with icotinib were reviewed retrospectively.All patients were treated with icotinib (125 mg,3 times a day) until disease progression,death or unacceptable toxicities.Results:In terms of intracranial lesions,the objective response rate(ORR) and disease control rate(DCR) were 7.7% and 84.6%.As for systemic disease,ORR and DCR were 11.5% and 76.9%,respectively.Total DCR was not related to age,sex,smoking status,pathological type,PS score,epidermal growth factor receptor(EGFR) mutation,the timing of icotinib treatment,the number of brain metastases (single or multiple) and brain radiotherapy and chemotherapy or not(P>0.05).The median progression-free survival(PFS) and median overall survival(OS) were 4 months (95%CI 2.4-5.6 months) and 8.3 months(95%CI 4.9-11.7 months),respectively.PFS was related to PS score and the mutation of EGFR in patients (P<0.01 and P<0.05)).OS was related to age,PS score,pathological type,EGFR status,and chemotherapy(P<0.05 to P<0.01).The side effects were tolerable,which were mainly mild rash and diarrhea.Conclusions:Icotinib may be effective on brain metastasis in NSCLC patients,and the toxicities are tolerable,which can be used as new treatment option for NSCLC patients with brain metastases.

       

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