Clinical Effectiveness Evaluation Study Of Chemotherapy And Small Molecular Targeted Therapeutic Of Gefitinib In Patients With Advanced Non-small-cell Lung Cancer

Objective: The purpose of this paper is to study clinical effectiveness evaluation ofchemotherapy and small molecular targeted therapy of gefitinib in patients withadvanced non-small-cell lung cancer. RECIST criteria and progression-free survival(PFS), postprogression survival (PPS) and overall survival (OS) is using in the efficacyevaluation and the relationship between some index is analyzed.Methods: Chemotherapy group: collected in our department of medical oncologyfrom2007.9to2010.1, admitted with pathologically confirmed stage IIIB/IV(seventhedition) or postoperative recurrence of60patients with advanced non-small-cell lungcancer. All patients completed the second-line treatment. Analysis of the effect ofpatients’ efficacy in first-line chemotherapy treatment on the progression-free survival(PFS)，overall survival (OS) and the relationship between some indicators. Gefitinibtargeted treatment group: collected40cases with advanced lung adenocarcinomabetween2009.1-2010.6months, the first-line treatment is gefitinib. Analyze if there issome difference between the progression-free survival (PFS) in patients’ therapeuticeffectiveness who achevived remission (CR+PR) and stable disease (SD). To draw thesurvival curves using SPSS17.0statistical software and Kaplan-Meier product limitanalysis method. Single factor analysis, Kaplan-Meier analysis, Log-rank, groupsbetween group and in the group, compared with the chi-square test, Cox regressionmodel, determine P＜0.05to have significant differences.Results: Chemotherapy group: the efficacy of first-line chemotherapy treatment,complete remission (CR)0cases, partial remission (PR)12cases, stable disease (SD)25cases, progressive disease (PD)23cases, the response rate (RR) is20%, the diseasecontronl rate (DCR) is61.7%; the effectiveness of second-line treatment, completeremission(CR)0cases, partial remission (PR)8cases, stable disease(SD)31cases, progressive disease(PD)21cases, RR is13.3%, DCR is65%. The mPFS of first-linechemotherapy is3.8months, the mPFS of second-line chemotherapy is3.5months, MSTin chemotherapy group is13.4months. First-line chemotherapeutic effectiveness inremission patients with PFS, OS are longer than the effectiveness of stable disease (PFS:7.5vs5.6months，P＜0.05; OS:17.8vs13.4months，P＜0.05). PFS for earlier achievedremission is longer than the later patients (PFS:10.3vs4.3months, P＜0.05)，but there isno significance difference in OS(19.1vs16.2months， P＜0.05).There is no linearcorrelation between the PFS for first-line chemotherapy and the PFS for second-linetreatment. There is linear correlation between PFS for the first-line chemotherapy andOS(R=0.467).There is strong linear correlation between PPS and OS(R=0.855).Gefitinib group:1case achieved CR,15cases achieved PR,20cases achieved SD,4casesachieved PD,RR is40%,DCR is90%.The overall mPFS is8.1months.There is nosignificant difference between mPFS for the response and mPFS for the stable diseasecondition(8.4vs7.8months, P＜0.05).Conclusion: PFS and OS for the first-line chemotherapy achieved response arelonger than stable disease. PFS for earlier achieved remission is longer than the later.PFS for the fisrst-line chemotherapy is longer, OS is longer. PPS is longer, OS is longer.After the first-line of gefitinib treatment, PFS for achieved remission and PFS forachieved stable condition has the same benefit.