Efficacy Of Erlotinib In Advanced Non-small Cell Lung Cancer And Survival Factor Analysis

Objective:This essay is aimmed to evaluate the efficacy and safety of Erlotinib,themedian overall survival time,median progression free survival time,responserate,disease control rate of the78patients with advanced non-small cell lung cancer andto identify the survival associated factors.Method:This data aims to analyze the clinical data of78cases of advancedNSCLC patients from Liaoning Provincial Tumor Hospital in the period from March5th2010to March5th2012that confirmed ⅢB or Ⅳ stage by diagonosis of pathologyor cytology.As to evaluate the efficacy and side effects,using SPSS statistical softwareto realize efficacy and survival univariate and multivariate analysis: using the chi-square test and logistic regression analysis to compare the different factors in responserate(RR) and disease control rate(DCR) whether there is statistically significant;survival analysis of the survival curve is plotted using the Kaplan-Meier method; usingthe log-rank test (log-rank) analysis of various factors on the survival time to seewhether there is statistically significant; Cox proportional hazards model is used formultivariate analysis.Result:All78patients were evaluable for efficacy, efficacy of CR was notobserved in all cases of patients.But others are PR19cases, SD34cases, PD25cases,RR24.3%, and DCR67.9%. Progression-free survival (PFS) was6.5months, overallsurvival (OS) was15months, and1-year survival rate was54.7%.Efficiency (RR)between the two groups for age, gender, histological type, PS score, EGFR mutationstatus, clinical stage, chemotherapy, smoking history has no significant difference (P>0.05). Except PS score and smoking history differences between the two groups inthe disease control rate (DCR) are statistically significant (P <0.05), age, gender,histological type, EGFR mutation, clinical stage and chemotherapy are no significantdifference (P>0.05):PS score0-1efficacy is better than that PS score≥2patients (78.8%vs.46.2%, P=0.005); non-smokers is more effective than smokers (60%vs.84.8%, P=0.024). Multivariate logistic regression analysis show that only PSscore is the independent factor for disease control rate (DCR).Using Log-rank test toanalyze single factor difference in survival, for median progression-free survival (PFS),in addition to chemotherapy factors is no significant difference (P>0.05), gender,age, PS score, histological type, disease stage, EGFR mutation status, smokinghistory and short-term efficacy difference are statistically significant (P <0.05). Butfor median overall survival (OS), in addition to pathological type and chemotherapydifference are not statistically significant (P>0.05), gender, age, PS score, stage ofdisease, EGFR mutation, smoking history and recent differences in efficacy arestatistically significant (P <0.05).The result of Cox multivariate model analysis, forthe median progression-free survival time (PFS), gender, PS score and pathologicaltype are seperately an independent prognostic factor; the same for median overallsurvival (OS), gender, and PS score can be considered as independent prognosticfactors. Statistical analysis shows that the58patients with skin toxicity get better RRand DCR than the other20patients without rash; and the PFS and OS islonger,too.Erlotinib common adverse reactions were mild, mostly Ⅰ,Ⅱdegree of skintoxicity and diarrhea, no adverse reactions due to reduction or withdrawal.Conclusion:1.As the good effectiveness, accepted toxicity and oralconvenience,erlotinib can be used in selected patients with advanced non-small cell lungcancer.2. Smoking history and PS score are independent impact factors forDCR.Not-smoking and lower PS score get better DCR rate.3. Gender, PS score andpathological types are the important factors that affect survival.The PFS of women, PSscore0-1points, patients with adenocarcinoma are longer than the other; The OS offemale patients, PS score0-1points are longer than the other.4. Skin rash bears relationto the response rate of erlotinib in patients with advanced non-small cell lungcancer.The patents with heavier rash have longer survival time.