Prognostic analysis of advanced non-small cell lung cancer patients with EGFR mutations in response to first-line treatment with EGFR-TKIs

何昊; 杨镇洲; 李钱; 张志敏; 蓝保华; 肖何; 吴艳; 李娟

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Prognostic analysis of advanced non-small cell lung cancer patients with EGFR mutations in response to first-line treatment with EGFR-TKIs

更新时间：2026-01-09

- Prognostic analysis of advanced non-small cell lung cancer patients with EGFR mutations in response to first-line treatment with EGFR-TKIs
- Journal of Army Medical University Vol. 38, Issue 7, Pages: 761-765(2016)
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  CLC： R181.32;R734.2;R979.12
- Published：2016
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何昊,杨镇洲,李钱,张志敏,蓝保华,肖何,吴艳,李娟.EGFR-TKIs一线治疗EGFR敏感突变非小细胞肺癌患者的预后分析[J].陆军军医大学学报(原第三军医大学学报),2016,38(07):761-765.

　He Hao,Yang Zhenzhou,Li Qian,Zhang Zhimin,Lan Baohua,Xiao He,Wu Yan,Li Juan.Prognostic analysis of advanced non-small cell lung cancer patients with EGFR mutations in response to first-line treatment with EGFR-TKIs[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(07):761-765.
何昊,杨镇洲,李钱,张志敏,蓝保华,肖何,吴艳,李娟.EGFR-TKIs一线治疗EGFR敏感突变非小细胞肺癌患者的预后分析[J].陆军军医大学学报(原第三军医大学学报),2016,38(07):761-765. DOI：

　He Hao,Yang Zhenzhou,Li Qian,Zhang Zhimin,Lan Baohua,Xiao He,Wu Yan,Li Juan.Prognostic analysis of advanced non-small cell lung cancer patients with EGFR mutations in response to first-line treatment with EGFR-TKIs[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(07):761-765. DOI：

摘要

目的探讨影响EGFR-TKIs一线治疗表皮生长因子受体(epidermal growth factor receptor，EGFR)敏感突变晚期非小细胞肺癌(non-small cell lung cancer，NSCLC)患者的预后因素。方法收集2010-2013年本院接受EGFR-TKIs一线治疗，并获得中国癌症基金会赠药的EGFR敏感突变晚期NSCLC患者114例。应用COX回归分析接受厄洛替尼/吉非替尼治疗后，影响患者脑转移进展发生和1、2、3年生存的预后因素，并进一步应用Kaplan-Meier法比较19和21外显子突变患者脑转移中位进展时间(time to neurological progression，nTTP)的差异。结果 114例患者中，17例治疗前即存在脑转移，14例在TKIs治疗期间出现脑转移，77.4%(24/31)在随访截止前出现脑转移进展。单因素分析显示：接受EGFR-TKIs治疗后，年龄60岁和≥60岁患者的1、2、3年生存率分别为90.15%、78.50%、63.30%和92.05%、57.90%、28.40%(P=0.038)；曾接受和未接受手术者的1、2、3年生存率分别为92.90%、86.45%、48.90%和90.85%、61.65%、27.30%(P=0.034)；无和有骨转移患者6、12、18个月脑转移进展发生率分别为3.40%、4.55%、10.90%和3.00%、11.70%、23.60%(P=0.046)。多因素分析显示：年龄≥60岁是EGFR-TKIs治疗中的独立死亡风险因素(P=0.024)；19和21外显子突变患者nTTP分别为18.3个月和13.0个月(P=0.276)。结论 60岁的EGFR敏感突变NSCLC患者接受TKIs治疗具有更低死亡风险，而合并骨转移者易发生脑转移，其中19外显子缺失突变脑转移患者具有更能从TKIs治疗获益的趋势。

Abstract

Objective To investigate the prognostic factors of epidermal growth factor receptor- tyrosine kinase inhibitors (EGFR-TKIs) in the first line treatment for advanced non-small cell lung cancer (NSCLC) patients with EGFR-mutation. Methods Clinical data of 114 NSCLC patients with EGFR-mutation who got donated medicine for EGFR-TKIs treatment (Erlotinib/Gefitinib) from the Cancer Foundation of China in our hospital during January 2010 and December 2013 were recruited in this study. Clinical factors of brain metastasis and prognostic factors for 1-

2- and 3-year survival were analyzed by Cox’s proportional hazards regression model. Brain metastasis of time to neurological progression (nTTP) between 2 EGFR mutations of exon 19 and 21 was analyzed by Kaplan-Meier survival analysis. Results In the 114 advanced NSCLC patients

17 patients had cerebral metastasis before TKIs treatment

14 patients had the metastasis during the treatment

and 24 (77.4%) out of 31 patients had the metastasis before the end of follow-up. Single factor analysis showed that the 1-

2- and 3-year survival rates were 90.15%

78.50% and 63.30%

and 92.05%

57.90% and 28.40% respectively for the 60-year-old and ≥60-year-old patients (P=0.038)

and the rates were 92.90%

86.45% and 48.90%

and 90.85%

61.65% and 27.30% respectively for those undergoing surgery and those not (P=0.034). The incidence of cerebral metastasis in 6

12 and 18 months after the treatment was 3.40%

4.55% and 10.90%

and 3.00%

11.70% and 23.60% respectively for those with bone metastasis and those without (P=0.046). Multiple factor analysis indicated that ≥60 years old was an independent risk factor for death in EGFR-TKIs treatment

and the nTTP of exon 19 and exon 21 patients were 18.3 and 13.0 months respectively (P=0.129). Conclusion The 60-year-old NSCLC patients with EGFR-mutation have lower risk of death in the treatment of EGFR-TKIs

and the patients with bone metastasis are prone to having cerebral metastasis

but those with exon 19 deletion may be benefited more from the treatment.

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