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背景与目的非小细胞肺癌(non-small cell lung cancer,NSCLC)脑转移患者接受一代表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor-tyrosine kinase inhibitors,EGFR-TKIs)的生存数据及影响因素未完全阐明。本研究对存在脑转移的NSCLC患者的生存数据进行分析,以期为指导临床实践提供一定的研究证据。方法回顾性收集上海交通大学附属胸科医院2012年-2013年确诊肺癌脑转移并接受一代EGFRTKIs治疗的病例。采用Kaplan-Meier单因素、Cox多因素分析方法,探讨NSCLC脑转移患者接受EGFR-TKIs的生存情况及影响因素。结果总体人群中位无进展生存时间(progression-free survival,PFS)为10.0个月(95%CI:8.3-11.7),中位生存时间(overall survival,OS)为28.0个月(95%CI:22.9-33.1)。病理组织类型、肿瘤分化程度分别是患者接受EGFR-TKIs后PFS、OS的独立影响因素(P分别为0.001、0.050)。结论 NSCLC脑转移患者接受一代EGFR-TKIs具有良好的疗效,腺癌亚型患者的PFS长于非腺癌患者,其他肿瘤分化程度患者的OS长于肿瘤低分化患者。
BACKGROUND & AIM: Patients with brain metastases from non-small cell lung cancer (NSCLC) survived a generation of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) Data and influencing factors are not fully elucidated. In this study, survival data of NSCLC patients with brain metastases were analyzed in order to provide some evidence for the clinical practice. Methods We retrospectively collected cases of chest metastasis of lung cancer diagnosed in 2012-2013 in Shanghai Chest Hospital affiliated to Shanghai Jiaotong University and receiving first-generation EGFRTKIs treatment. Kaplan-Meier single factor and Cox multivariate analysis were used to investigate the survival and influencing factors of EGFR-TKIs in NSCLC patients with brain metastasis. Results The overall population progression-free survival (PFS) was 10.0 months (95% CI: 8.3-11.7) and overall survival (OS) was 28.0 months (95% CI: 22.9-33.1). The pathological type and tumor differentiation were independent factors of PFS and OS in patients receiving EGFR-TKIs (P = 0.001,0.050, respectively). Conclusions NSCLC patients with brain metastases have a good effect of receiving EGFR-TKIs. The PFS of patients with adenocarcinoma is longer than that of patients with non-adenocarcinoma. The OS of other patients with differentiated tumors is longer than that of patients with poorly differentiated tumors.