ABSTRACT
Objective To evaluate the efficacy and safety of gefitinib combined with concurrent thoracic radiotherapy in the treatment of local - advanced non - small cell lung cancer with sensitive EGFR mutations. Methods From June 2015 to December 2016,fifty-six eligible patients in Chongqing Three Gorges Central Hospital were randomly assigned into two groups by one to one ratio,with 28 cases in each group.A group received treatment of gefitinib combined with concurrent thoracic radiotherapy, and B group adopted concurrent chemoradiotherapy. The toxic effects were recorded and all patients were followed up as defined by the study protocol.Primary study endpoints included:severe toxic effects,objective response rate and disease control rate,progression free survival and overall survival.Results Twenty-six patients in A group completed the study,and the severe toxic effects were as followed:interstitial pneumonia(3/26),radiation esophagitis(4/26),myelosuppression,skin rashes and gastrointestinal disruption. Twenty- eight patients in B group completed the study, and the severe toxicity included: interstitial pneumonia (4/26),radiation esophagitis(3/26),myelosuppression,skin rashes and gastrointestinal disruption.No toxicity higher than gradeⅢdeveloped in both two groups,and there were no statistically significant differences in incidence rates of interstitial pneumonia and radiation esophagitis between the two groups ( all P >0. 05 ). Moreover, there were no statistically significant differences in ORR and DCR between the two groups( ORR:61.5% vs.39.3% ,P=0.102;DCR:84. 6% vs. 71. 4% , P =0. 505 ). A group showed the benefit over B group in PFS ( 12. 45 months vs. 10.35 months,P=0.036).However,OS didn＇t reach and needed further follow-up.Conclusion The modality of gefitinib combined with concurrent thoracic radiotherapy in the treatment of local -advanced non -small cell lung cancer with sensitive EGFR mutations is safe and effective,and it yet needs further follow-up.
ABSTRACT
Objective To explore the expression of zinc finger protein 217 (ZNF217) in non-small cell lung cancer (NSCLC) and its correlation with prognosis of patients. Methods A total of 120 NSCLC patients in Chongqing Three Gorges Central Hospital from January 2012 to October 2013 were selected. Immunohistochemical method was used to test the expression of ZNF217 in NSCLC tissues and paracancerous tissues. The correlation of ZNF217 expression with patient's clinicopathological features was analyzed. At the same time, the Kaplan-Meier method and Cox regression model multiple factor analysis method were used to explore the factors affecting the prognosis of patients after NSCLC radical operations. Results ZNF217 mainly existed in cell nucleus of NSCLC. The positive expression rate of ZNF217 in the cancer tissues was higher than that in the paracancerous tissues [52.5％ (63/120) vs. 20.1％ (25/120), χ 2 = 25.909, P < 0.05]. The positive expression rate of ZNF217 increased with the increase of tumor T stage (χ 2 = 7.333, P = 0.026), N stage (χ 2 = 7.782, P = 0.020) and TNM stage (χ 2 = 11.557, P = 0.003). The overall survival (P = 0.007) and progression-free survival (P = 0.004) of patients with positive ZNF217 were poorer than those of patients with negative ZNF217. Cox multiple factor analysis showed that ZNF217 was an independent risk factor affecting the prognosis of NSCLC. Conclusion ZNF217 is an independent risk factor affecting the prognosis of NSCLC, and it may be a potential target for accurate treatment of NSCLC.