| BackgroundNon-small cell lung cancer is the most common cancer in the world. Most of thepatients with NSCLC lost early surgery because they are diagnosed at advanced stages(stage Ⅲ b and Ⅲ). Despite advances in treatment, such as combination chemotherapyand radiotherapy, the survival has improved very little. In recent years, with the adventof EGFR-TKI (such as gefitinib and erlotinib), the patients can obtain benefits.EGFR-TKI has been documented to highly improve overall survival especially in thepatinents who are "Asian, non-smoking, women, adenocarcinoma". EGFR-TKI hasmildly adverse event.Oral medication administration is easily for patients with NSCLC.At present, EGFR-TKI treatment of NSCLC is the hot issues.Overall survival,progression-free survival, disease-free survival and the efficacy of predictive factorshave been reported in many authoritative studies.Many authoritative studies wereconducted to clarify the effectiveness of EGFR-TKI as first-line, second-line, third-lineand maintenance to therapy the patients with NSCLC.However, regardless of the high efficacy, patients who will eventually acquiredresistance to the regimen in spite of initial responses to EGFR-TKI. How to choicefollow-up treatment is relatively unknown until now. If the patients have a strongintention to treatment, the doctors cannot immediately to stop the anti-tumortherapy.Whether the patient requires immediate replacement drugs or only palliativetreatment? The failure mainly due to the primary lung lesion progression, brainmetastases and bone metastases. And there are1ack of reports resolve it. Therefore, the study via gefitinib treatment of advanced NSCLC clinical data to explore the aboveissues and provide a treatment method for the patients who acquired resistance to theregimen in spite of initial responses to it.ObjectivesTo observe the clinical manifestation，quality of life and follow-up survival timeof patients with NSCLC who had initial response to gefitinib for more than6monthsand maintained administration of the regimen even after failure of gefitinib.MethodsGefitinib was taken orally at a dosage of250mg daily. The NSCLC patients weredivided into the trail group (whose disease progressed) and the control group (whosedisease didn’t progress) who had been administrated the regimen successfully more than6months. Quality of life for patients with KPS and FLIC were evaluated. The follow-upsurvival time of the target lesions progression and the non-target lesions progressionwere calculated.ResultsThe trail group and the control group were thirty-nine and forty-nine respectively. Thefavorable scores of KPS and FLIC were still kept on1~24months to the patients in thetrail group, and the median time was6months. KPS and FLIC scores were compared bythe two groups, and the differences were no significance （Z=-0.976,P=0.329;Z=-0.029,P=0.977）. In the trail group, during the period of initial progress to disease flare and in the period of disease flare to death, the scores of KPS were85.00±7.31、48.00±9.25respectively, the difference was significance（P <0.001）; andthe scores of FLIC were121.24±18.16、75.57±21.45respectively, the difference wassignificance（P <0.001）. The median follow-up survival time of patients with the targetlesion progress and with non-target lesions progress were7months and10monthsrespectively in the trail group, the difference was significance (P=0.018). ConclusionThe patients with NSCLC could gain clinical benefits from continuing theadministration of gefitinib, who acquired resistance to the regimen in spite of initialresponses to it, especially for the patients with non-target lesion progress. |
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