| Gaowa Jin,Wenjuan Wang,Shuqin Deng,Caihong Jiang,Xiaojun Bai,Jun Zhao,Feng Chen,Jixiang Hou,Lanzhen Zhao,Hui Li,Ziyu Lu,Lenggaowa Da,Yungaowa Wu,Xiaoyun Ma,Yahan Wu,Jiali Gao,Quanfu Li. Treatment and survival status of patients with EGFR mutation-positive stage IV lung adenocarcinoma: five-year follow-up results in the Ordos Area of Inner Mongolia, China. Oncol Transl Med, 2018, 4: 158-162. |
| 内蒙古鄂尔多斯地区EGFR基因突变阳性晚期肺腺癌5年治疗生存随访结果 |
| Treatment and survival status of patients with EGFR mutation-positive stage IV lung adenocarcinoma: five-year follow-up results in the Ordos Area of Inner Mongolia, China |
| Received:June 16, 2018 Revised:September 10, 2018 |
| DOI：10.1007/s10330-018-0281-1 |
| 中文关键词: 表皮生长因子受体；TKI;真实世界；预后研究；少数民族地区； |
| 英文关键词: epidermal growth factor receptor (EGFR); tyrosine kinase inhibitor (TKI); minority areas |
| 基金项目:内蒙古自治区卫生计生委基金；吴阶平基金 |
| Author Name | Affiliation | E-mail | | Gaowa Jin | Department of Medical Oncology, Ordos Central Hospital | jingaowank@163.com | | Wenjuan Wang | Department of Medical Oncology, Ordos Central Hospital | | | Shuqin Deng | Department of Medical Oncology, Ordos Central Hospital | | | Caihong Jiang | Department of Medical Oncology, Ordos Central Hospital | | | Xiaojun Bai | Department of Medical Oncology, Ordos Central Hospital | | | Jun Zhao | Department of Medical Oncology, Ordos Central Hospital | | | Feng Chen | Department of Medical Oncology, Ordos Central Hospital | | | Jixiang Hou | Department of Medical Oncology, Ordos Central Hospital | | | Lanzhen Zhao | Department of Medical Oncology, Ordos Central Hospital | | | Hui Li | Department of Medical Oncology, Ordos Central Hospital | | | Ziyu Lu | Department of Medical Oncology, Ordos Central Hospital | | | Lenggaowa Da | Department of Medical Oncology, Ordos Central Hospital | | | Yungaowa Wu | Department of Medical Oncology, Ordos Central Hospital | | | Xiaoyun Ma | Department of Medical Oncology, Ordos Central Hospital | | | Yahan Wu | Department of Medical Oncology, Ordos Central Hospital | | | Jiali Gao | Department of Medical Oncology, Ordos Central Hospital | | | Quanfu Li* | Department of Medical Oncology, Ordos Central Hospital | 1729259137@qq.com |
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| 中文摘要: |
| 目的：研究鄂尔多斯地区晚期肺腺癌EGFR基因突变状态以及突变患者治疗生存状态；材料和方法：分析鄂尔多斯地区2012年6月至2017年6月EGFR基因检测率和一线TKI治疗率，Kaplan–Meier生存曲线比较对EGFR突变患者接受不同全程管理策略的生存情况；结果：EGFR基因检测率五年来不断提升，检测率 达到65.60%，EGFR基因突变率为 52.90%。EGFR基因突变患者中, EGFR 19 del占38.9%, L858R突变占48.2% had, 19 缺失和21突变同时存在占4.2%, 少见突变占8.4% . 在全程管理中既接受靶向和化疗，只接受靶向或只接受化疗的患者中位生存时间分别是 29.5 月, 26.5 月和 16.0 月(P =0.047). 对于 EGFR 19 del和 L858R 突变全程只接受TKI治疗患者中位 OS 分别是26.5 月和 30.0月 (P =0.096).结论：鄂尔多斯地区较高的晚期肺腺癌中位生存时间得益于不断提高的EGFR基因检测率和一线TKI治疗率。在分子靶向治疗时代，同样应该强调化疗对于总生存延长的重要意义。 |
| 英文摘要: |
| Objective We aimed to determine the epidermal growth factor receptor (EGFR) mutation status and
treatment survival of patients with stage IV lung adenocarcinoma living in the Ordos area of Inner Mongolia,
China.
Methods EGFR testing and first-line tyrosine kinase inhibitor (TKI) treatment rates of patients with stage
IV lung adenocarcinoma were analyzed from June 2012 to June 2016. Kaplan-Meier survival curves were
constructed to compare patients who received different treatment strategies and those harboring different
EGFR mutation statuses.
Results EGFR testing and mutation rates were 65.60% and 52.90%, respectively, and improved
continuously from June 2012 to June 2016. Among patients with EGFR mutations, 38.9% had EGFR 19
del, 48.2% had L858R, 4.2% had co-existing mutations in exons 19 and 21, and 8.4% had uncommon
mutations. The median overall survival (OS) was 29.5, 26.5, and 16.0 months for patients receiving both
TKI and chemotherapy, TKI alone, and chemotherapy alone, respectively (P = 0.047). The OS was 26.5
and 30.0 months for patients harboring EGFR 19 del and L858R mutations, respectively (P = 0.096).
Conclusion The high OS rates of stage IV lung adenocarcinoma patients living in the Ordos area may be
attributed to continuous improvements in EGFR testing and first-line TKI treatment rates. In the era of TKIs,
chemotherapy for increasing OS times should be emphasized. |
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