中医辨证治疗联合埃克替尼对EGFR突变老年晚期肺腺癌患者生存期的影响
Effect of traditional Chinese medicine syndrome differentiation and treatment combined with Icotinib on survival of elderly patients with EGFR-mutant advanced lung adenocarcinoma
- 上海中医药杂志 2021年55卷第4期 页码：40-44
- 作者机构：
1.上海中医药大学附属龙华医院肿瘤六科（上海 200032）
2.上海交通大学附属胸科医院呼吸内科（上海 200030）
- 作者简介：
沈丽萍，女，硕士，主治医师，主要从事中医药防治恶性肿瘤的临床与研究工作
刘苓霜，主任医师，博士研究生导师；E-mail：liuls107@163.com
- 基金信息：上海市卫计委科研项目(201440436);上海中医药大学附属龙华医院国家中医临床研究基地“龙医学者”（育苗计划）项目(LYTD81);上海申康市级医院新兴前沿技术联合项目(SHDC12018124);上海市科委 “科技创新行动计划”临床医学领域科技支撑项目(19401971200);上海市卫计委“第三届国医大师传承工作室”项目(DSGZS-2017002)
DOI：10.16305/j.1007-1334.2021.2011071
中图分类号：
扫 描 看 全 文
沈丽萍, 刘苓霜, 姜怡, 等. 中医辨证治疗联合埃克替尼对EGFR突变老年晚期肺腺癌患者生存期的影响[J]. 上海中医药杂志, 2021,55(4):40-44.
Liping SHEN, Lingshuang LIU, Yi JIANG, et al. Effect of traditional Chinese medicine syndrome differentiation and treatment combined with Icotinib on survival of elderly patients with EGFR-mutant advanced lung adenocarcinoma[J]. Shanghai Journal of Traditional Chinese Medicine, 2021,55(4):40-44.
沈丽萍, 刘苓霜, 姜怡, 等. 中医辨证治疗联合埃克替尼对EGFR突变老年晚期肺腺癌患者生存期的影响[J]. 上海中医药杂志, 2021,55(4):40-44. DOI： 10.16305/j.1007-1334.2021.2011071.
Liping SHEN, Lingshuang LIU, Yi JIANG, et al. Effect of traditional Chinese medicine syndrome differentiation and treatment combined with Icotinib on survival of elderly patients with EGFR-mutant advanced lung adenocarcinoma[J]. Shanghai Journal of Traditional Chinese Medicine, 2021,55(4):40-44. DOI： 10.16305/j.1007-1334.2021.2011071.
摘要
目的,2,观察中医辨证治疗联合埃克替尼对表皮生长因子受体（EGFR）突变老年晚期肺腺癌患者生存期的影响。,方法,2,将74例EGFR突变老年晚期肺腺癌患者随机分为治疗组和对照组，每组37例，对照组单用埃克替尼治疗，治疗组在此基础上加用中医辨证汤剂。观察治疗后疾病发生进展及死亡的时间，计算中位疾病无进展生存期（mPFS）及中位生存期（MST）。,结果,2,①随访至2020年7月30日，治疗组脱落1例、对照组脱落2例，共纳入71例病例进行统计，其中治疗组36例、对照组35例。②治疗组、对照组mPFS分别为15.40个月、13.07个月，组间差异有统计学意义（,P,=0.024，,HR,=0.575）。③治疗组、对照组的MST分别为29.90个月、25.07个月，组间差异有统计学意义（,P,=0.045，,HR,=0.580）。④多因素分析结果显示，联合中医药治疗、一线埃克替尼治疗、曾经接受肺癌根治术、较少的合并症是影响EGFR突变老年晚期肺腺癌患者远期生存预后的独立保护因素（,P,<,0.05）。,结论,2,中医辨证治疗联合埃克替尼可延长EGFR突变老年晚期肺腺癌患者的无进展生存期及总生存期，一线埃克替尼治疗阶段、肺癌根治术及较少的合并症也有利于老年晚期肺腺癌患者的远期生存预后。
Abstract
Objective,2,To observe the effect of traditional Chinese medicine (TCM) syndrome differentiation and treatment combined with Icotinib on the overall survival of elderly patients with advanced lung adenocarcinoma with epidermal growth factor receptor (EGFR) mutation.,Methods,2,A total of 74 elderly patients with EGFR-mutant advanced lung adenocarcinoma were randomly divided into treatment group (,n,=37) and control group (,n,=37). The control group was administered with Icotinib alone, and the treatment group was additionally administered with TCM decoction based on syndrome differentiation besides Icotinib. The time of disease progression and death after treatment in the two groups was observed, and the median progression-free survival (mPFS) time and median survival (MST) time were calculated.,Results,2,①As of July 30,th, 2020, 71 patients were finally included after follow-ups for statistical analysis with one drop-out case in the treatment group (,n,=36) and two drop-out cases in the control group (,n,=35). ②The mPFS of the treatment group and the control group were 15.40 months and 13.07 months respectively, with significant difference between the two groups (,P,=0.024,HR,=0.575); ③The MST of the treatment group and the control group were 29.90 months and 25.07 months respectively, with significant difference between the two groups (,P,=0.045,HR,=0.580). ④Multivariate analysis showed that combined treatment of traditional Chinese medicine, first-line Icotinib treatment, previous radical resection of lung cancer, and fewer comorbidities were independent protective factors affecting the long-term survival and prognosis of elderly patients with EGFR-mutant advanced lung adenocarcinoma (,P,<,0.05).,Conclusion,2,TCM syndrome differentiation and treatment combined with Icotinib can prolong the progression-free survival and overall survival of elderly patients with EGFR-mutant advanced lung adenocarcinoma. The first-line Icotinib treatment stage, radical resection of lung cancer and fewer comorbidities are also conducive to the long-term survival prognosis of elderly patients with advanced lung adenocarcinoma.
关键词
肺腺癌非小细胞肺癌晚期埃克替尼生存期预后中医药疗法
Keywords
lung adenocarcinomanon-small cell lung canceradvancedIcotinibsurvivalprognosistraditional Chinese medicine therapy
references
OWONIKOKO T K, RAGIN C C, BELANI C P, et al. Lung cancer in elderly patients: an analysis of the surveillance, epidemiology, and end results database[J]. J Clin Oncol, 2007, 25(35): 5570-5577.
DAVIDOFF A J, TANG M, SEAL B, et al. Chemotherapy and survival benefit in elderly patients with advanced non-small-cell lung cancer[J]. J Clin Oncol, 2010, 28(13): 2191-2197.
SHI J F, WANG L, WU N, etal. Clinical characteristics and medical service utilization of lung cancer in China, 2005-2014: Overall design and results from a multicenter retrospective epidemiologic survey[J/OL]. Lung Cancer, 2019, 128: 91-100[2020-11-10]. https://pubmed.ncbi.nlm.nih.gov/30642458/https://pubmed.ncbi.nlm.nih.gov/30642458/.
沈丽萍，刘苓霜，姜怡，等. 扶正解毒法联合盐酸埃克替尼治疗老年晚期肺腺癌的临床研究[J]. 天津中医药大学学报，2019, 38(5): 445-451.
支修益，石远凯，于金明. 中国原发性肺癌诊疗规范（2015年版）[J]. 中华肿瘤杂志，2015, 37(1): 67-78.
DETTERBECK F C, BOFFA D J, TANOUE L T. The new lung cancer staging system[J]. Chest, 2009, 136(1): 6-8.
国家药品监督管理局. 中药新药临床研究指导原则（试行）[M]. 北京：中国医药科技出版社，2002: 216-221.
GOTO K, NISHIO M, YAMAMOTO N, et al. A prospective, phase Ⅱ, open-label study (JO22903) of first-line erlotinib in Japanese patients with epidermal growth factor receptor (EGFR) mutation-positive advanced non-small-cell lung cancer (NSCLC)[J]. Lung Cancer, 2013, 82(1): 109-114.
KUWAKO T, IMAI H, MASUDA T, et al. First-line gefitinib treatment in elderly patients （aged≥75 years） with non-small cell lung cancer harboring EGFR mutations[J]. Cancer Chemother Pharmacol, 2015, 76(4): 761-769.
石远凯，孙燕，丁翠敏，等. 中国埃克替尼治疗非小细胞肺癌专家共识（2016年版）[J].中国肺癌杂志，2016, 19(7): 489-493.
任一理，生金，周小芸，等. 埃克替尼治疗表皮生长因子受体敏感突变型高龄晚期非小细胞肺癌患者的临床疗效[J]. 中华肿瘤杂志，2019, 41(2): 152-153.
IMAIA H, YAMADAB Y, SUGIYAMAC T, et al. Clinical impact of post-progression survival on overall survival in elderly patients with non-small-cell lung cancer harboring sensitive EGFR mutations treated with first-line EGFR tyrosine kinase inhibitors[J]. Chemotherapy, 2018, 63(3): 181-190.
谢泽萍，文凤，李纬，等. 免疫衰老在肿瘤及其免疫疗法中的研究进展[J]. 中国肿瘤，2019, 28(12): 934-940.
刘嘉湘，田建辉. 传承中医药学术精华，促进肿瘤学创新发展[J]. 上海中医药杂志，2020, 54(7): 29-33.
刘苓霜，张朋，姜怡，等. 中医扶正法治疗肺癌的临床疗效及其对机体的免疫调节作用[J]. 自然杂志，2019, 41(4): 281-286.
辛晓丽，姜怡，沈丽萍，等. 中医药辅助治疗600例老年非小细胞肺癌患者的生存分析[J]. 中医杂志，2019, 60(1): 31-35.
李爱武，周彩存，徐建芳. 年龄与并发症对老年晚期非小细胞肺癌患者治疗和生存期的影响[J]. 肿瘤，2008, 28(7): 596-600.
刘苓霜，姜怡，沈丽萍，等. 103例老年晚期非小细胞肺癌中医药治疗的回顾性研究[J]. 上海中医药大学学报，2011, 25(6): 26-29.
0
浏览量
204
下载量
0
CSCD
5
CNKI被引量
- 网络PDF下载
- Meta-XML下载
- BibTeX下载
- Endnote下载
- RefMan 下载
- NoteExpress下载
- NoteFirst下载
关联资源
相关文章
相关作者
相关机构
- 技术支持由北京北大方正电子有限公司提供 沪ICP备13044091号
沪公网安备 31011502015228号 - 本系统建议在Chrome、 IE9+ 以上版本浏览器阅读本站内容，360浏览器请切换至极速模式
- Cookies帮助我们提供服务并提供个性化体验。使用本网站，即表示您同意我们使用Cookies
- 总访问量：70551 今日访问量：32