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目的 探究伏美替尼治疗非小细胞肺癌脑转移（NSCLC）患者的临床效果及对生存预后的影响。方法 选取2021年3-12月海军安庆医院呼吸内科收治的76例NSCLC脑转移患者的病历资料进行回顾性分析。根据治疗方案将其分为研究组（33例）和对照组（43例），对照组予以全脑放疗，研究组在对照组基础上联合口服伏美替尼。治疗3个月后，比较2组的疾病控制率、客观缓解率、血清肿瘤标志物水平及药物不良反应，所有受试者均跟踪随访12个月，记录2组患者的总生存期（OS）、无进展生存期（PFS）。结果 研究组客观缓解率、疾病控制率均高于对照组（P<0.05）。治疗3个月后，2组血清癌胚抗原（CEA）、角蛋白19片段抗原21-1(CYFRA21-1)水平均低于治疗前，且研究组低于对照组（P<0.05）。研究组和对照组PFS分别为7.5个月和5.0个月，2组PFS生存曲线比较差异有统计学意义（P<0.05）。研究组1年OS率分别为75.00%和52.50%,2组1年OS生存曲线比较差异有统计学意义（P<0.05）。2组骨髓抑制、腹泻、皮疹、咳嗽、上呼吸道或口腔黏膜感染发生率比较差异无统计学意义（P>0.05）；研究组转氨酶升高比例高于对照组（P<0.05）。结论 伏美替尼治疗NSCLC脑转移患者，不仅可提高患者的客观缓解率及疾病控制率，还可有效延长患者的PFS及OS，且整体安全性良好，但可能会增加转氨酶升高风险。
Abstract：Objective To explore the clinical efficacy of furmonertinib in the treatment of brain metastasis from non-small cell lung cancer( NSCLC) and its impact on survival and prognosis.Methods The medical records of 76 patients with NSCLC brain metastasis who were admitted to Anqing Hospital of Navy from March to December 2021 were retrospectively analyzed. According to the treatment plan, they were divided into study group( 33 cases) and control group( 43 cases). The control group was treated with whole brain radiotherapy, and the study group was given oral furmonertinib on the basis of the control group. After 3 months of treatment, disease control rate, objective remission rate, serum tumor marker levels and adverse drug reactions were compared between the two groups. All the patients were followed up for 12 months, and the overall survival( OS) and progression free survival(PFS) were recorded.Results The objective remission rate and disease control rate in the study group were higher than those in the control group(P<0. 05). After 3 months of treatment, serum carcinoma embryonic antigen(CEA) and cytokeratin 19 fragment(CYFRA21-1) were decreased in both groups, and the two indexes in the study group were lower than those in the control group( P<0. 05). The PFS of the study group and control group were 7. 5 months and 5. 0 months, respectively. The one-year OS of the study group and control group was 75. 00% and 52. 50%, respectively. There were statistically significant differences in the survival curves of PFS and one-year OS between the two groups(P<0. 05). No significant difference was found in the incidences of myelosuppression, diarrhea, rash, cough, upper respiratory tract or oral mucosal infection between the two groups(P>0. 05). The proportion of patients with increased transaminase in the study group was higher than that in the control group(P<0. 05).Conclusion Furmonertinib can not only improve the objective remission rate and disease control rate of patients with NSCLC brain metastasis, but also effectively prolong the PFS and OS, with good safety. However, it may increase the risk of transaminase elevation.
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DOI：
中图分类号:R734.2
引用信息:
[1]陈焕,刘宜根,吴孙,等.伏美替尼在非小细胞肺癌脑转移中的应用效果及生存分析[J].海军医学杂志,2024,45(12):1317-1321.
基金信息: