Comparison Of The Influence Of Treatment On Quality Of Life Between Non-small Cell Lung Cancer Patients Who Have A Response To Gelltinib More Than Six Months With High And Low ECOG-PS Score

Background: The efficacy of epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI) in the treatment of non-small cell lung cancer has been recognized. It canprolong survival, while for NSCLC patients with Eastern Cooperative Oncology Group(ECOG) performance status (PS)≥3is still controversial. There has been many reportson the study of the special group overseas. However, the related study is short in Chinaand the treatment of this part is neglected. There are racial differences between Chineseand foreigners, thus a further study on field is needed.Objective: To observe the efficacy, quality of life and toxicity of gefitinib in non-smallcell lung cancer (NSCLC) patients who have a response to gefitinib more than6monthswith ECOG PS≥3.Methods: A total of88NSCLC patients with Eastern Cooperative Oncology GroupECOG PS≥3were enrolled into this prospective study in the department of oncology,second affiliated hospital of Anhui Medical University from September2006toNovember2011. NSCLC patients with histological and/or cytological confirmed weredivided into trial group (PS≥3) and control group (PS≤2), and all of them were treatedwith a dose of250mg/d gefitinib until obvious disease progression or death.Extenuation or withdrawal would be given if patients can not tolerate toxicity during thetime. Patients with Brain and bone metastases could be treated with radiotherapy conditionally at the same time. Their carry-over efficacy, quality of life and toxicitywere evaluated. The clinical data were analyzed by using rank sum test, Kaplan-Meiermethod and Log-rank test.Results: A total of eighty-eight patients were enrolled in this trial. We followed up thesepatients until30-Nov-2012, the median follow up time was20.0months. Eighty-eightcases were not lost. All patients in the two groups were evaluable. The CR, PR and SDof the trial group and the control group were4(14.81%) vs10patients (16.39%),20(74.07%) vs43patients (70.49%) and3(11.11%) vs8patients (13.11%) respectively.The response rate, disease control rate, the median symptom improving time were88.89%(24/27) vs86.89%(53/61)(Z=-0.261, P=0.794),100%vs100%(Z=0.000,P=1.000) and10.0d vs14.0d (Z=-1.792, P=0.073) respectively. The median OS andPFS were10.0months vs14.0months（Z=-0.276, P=0.784）and8.0months vs7.0months (Z=-0.539, P=0.421）respectively. The1-,2-,3-year survival rates were59.26%(16/27) vs57.38%(35/61),25.93%(7/27) vs21.31%(13/61) and3.70%(1/27) vs6.56%(4/61) respectively (P=0.180). PS and FLIC scores ascended dramatically in thetwo groups before and after treatment (P=0.000,0.000respectively), yet the trial grouprose even more (PS and FLIC scores were Z=-7.600and Z=-7.483respectively, P=0.000,0.000respectively). The toxicities of gefitinib were both insignificant.Conclusion: Gefitinib can be safely applied in NSCLC patients with ECOG-PS score≥3. There is no difference in survival time between NSCLC patients with ECOG-PSscore≥3and≤2, but quality of life in NSCLC patients ECOG-PS score≥3issignificantly improved as compared with NSCLC patients with NSCLC patientsECOG-PS score≤2after gefitinib therapy. We continued with gefitinib while diseaseprogression, quality of life was not positively correlated with disease progression in acertain period time.