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Objective:To investigate the efficacy of concurrent chemoradiotherapy combined with icotinib targeted therapy for patients with epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC).Methods:A total of 89 EGFR-mutated NSCLC patients who were admitted to Shanxi Province Cancer Hospital from January 2017 to January 2019 were selected and divided into control group (45 cases) and observation group (44 cases) by random number table method. The control group received cisplatin combined with docetaxel concurrent chemoradiotherapy, the observation group received cisplatin combined with docetaxel concurrent chemoradiotherapy and oral icotinib targeted therapy. The blood coagulation function, immune function and levels of tumor markers were compared between the two groups.Results:There was no statistical difference in blood coagulation function, immune function and levels of tumor markers between the two groups before treatment (all P > 0.05). After treatment, the levels of fibrinogen [(13±4) g/L vs. (16±6) g/L], D-dimer [(1.0±0.8) mg/L vs. (1.4±1.0) mg/L], squamous cell carcinoma antigen [(0.97±0.23) μg/L vs. (1.11±0.21) μg/L], carbohydrate antigen 125 [(21±7) U/ml vs. (35±11) U/ml] and carcinoembryonic antigen [(2.2±0.3) ng/ml vs. (6.0±1.1) ng/ml] in the observation group were lower than those in the control group, and the differences were statistically significant ( t values were 2.84, 2.11, 3.08, 7.40 and 23.08, all P < 0.05). After treatment, the ratios of NK cells [(18±7)% vs. (15±4)%], cytotoxic T cells [(17.2±6.1)% vs. (14.7±3.6)%] and helper T cells [(31.03±0.11)% to (25.88±0.39)%] in the observation group were higher than those in the control group, and the differences were statistically significant ( t values were -2.91, -2.59 and 2.79, all P < 0.05). Conclusions:Concurrent chemoradiotherapy combined with icotinib targeted therapy can better improve the hypercoagulable state and levels of tumor markers in patients with EGFR-mutated NSCLC than simple concurrent chemoradiotherapy, and can improve the immune function of patients, which has good therapeutic efficacy.
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Objective To analyze the efficacy of gefitinib in the first-line and the second-line treatment of advanced non-small cell lung cancer (NSCLC) with different mutations of epidermal growth factor receptor (EGFR). Methods The clinical data of 70 patients with advanced NSCLC harboring different EGFR mutations and taking gefitinib as the first-line or the second-line treatment in Shanxi Provincial Cancer Hospital from January 2013 to December 2014 was analyzed retrospectively. According to the treatment method, the patients were divided into the first-line treatment group (36 cases) and the second-line treatment group (34 cases); according to the type of gene mutations, the patients were divided into exon 19 deletion group (EGFR gene exon 19 LREA deletion, 46 cases) and exon 21 mutation group (exon 21 L858R mutation, 24 cases). Progression-free survival (PFS), effective rate (ORR), and disease control rate (DCR) were observed in each group. Results Of the 70 evaluable patients, the median PFS time in patients with exon 19 LREA deletion was 8.88 months (95％ CI 7.72-10.04), and the median PFS time in patients with exon 21 L858R mutation was 8.67 months (95％ CI 7.17-10.17), the difference between the two groups was not statistically significant (P = 0.959). The ORR in patients with exon 19 LREA deletion was 69.6％ (32/46), and the ORR inpatients with exon 21 L858R mutation was 54.2％ (13/24), the difference was not statistically significant (χ 2= 1.629, P = 0.202). The DCR in patients with exon 19 LREA deletion was 84.8％ (39/46), and the DCR in patients with exon 21 L858R mutation was 91.7％ (22/24), the difference was not statistically significant (χ 2= 0.194, P = 0.659). The median PFS time in patients with the first-line treatment was 9.22 months (95％ CI 7.92-10.52), and the median PFS time in patients with the second-line treatment was 8.37 months (95％ CI 7.08-9.65), the difference was not statistically significant (P = 0.507). The ORR in patients with the first-line treatment was 63.9％ (23/36), and the ORR in patients with the second-line treatment was 58.8％ (20/34), the difference was not statistically significant (χ 2 = 1.460, P = 0.227). The DCR in patients with the first-line treatment was 88.9％ (32/36), and the DCR in patients with the second-line treatment was 88.2％ (30/34), the difference was not statistical significant (χ 2 = 0.060, P = 0.940). Conclusion The short-term efficacy and PFS are similar between NSCLC patients with different mutations of EGFR or with the first-line and the second-line treatment with gefitinib.
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Objective To retrospectively analyze the elderly patients with inoperable locally advanced squamous cell lung cancer,and determine prognostic factors.Methods According to eligibility criterion,162 cases of elderly patients with inoperable locally advanced squamous cell lung cancer were selected from January 1,2010 to January 1,2015 in Shanxi Tumor Hospital.Related prognostic factors were carried on univariate and multivariate analysis with Kaplan-Meier approach and Cox regression,respectively.Results The median age of 162 patients was 73.6 years old.The overall median survival time was 19.4 months.The 1-year survival rate was 71.0％,and the 2-year survival rate was 35.9％.In univariate analysis with Kaplan-Meier analysis method:age (x2 =7.94,P =0.005),Eastern Cooperative Oncology Group (ECOG) score (x2 =42.12,P =0.000),chemotherapy combined with radiotherapy or not (x2 =14.99,P =0.000) were prognostic factors that influenced survival.Cox regression analysis showed that ECOG score (HR =0.30,95％ CI:0.19-0.46,P =0.000) and N stage (HR =0.65,95％ CI:0.44-0.95,P =0.026) were independent prognostic factors.Conclusion ECOG score and N stage are independent prognostic factors of the elderly patients with inoperable locally advanced squamous cell lung cancer.