Clinical Observation Of Icotinib In The Treatment For 138 Cases Of Elderly Patients With Non-small Cell Lung Cancer

Objective:To analyze and discuss the clinical characteristics and therapeutic effect of icotinib in treating elderly patients with non-small cell lung cancer(NSCLC),so as to provide some research basis for clinical diagnosis and treatment and prognosis evaluation of the crowd.Methods: Retrospective analysis was carried out on a total of 138 cases of elderly patients aged 70 or above,with NSCLC and treated in Guangxi Zhuang Autonomous Region Cancer Hospital from January 2013 to January 2016.The patients all had received single-drug icotinib oral therapy,with 125 mg each time and 3 times daily,until the disease progressed or intolerable adverse event occurred.The effect and safety of the therapy were observed,the clinical characteristics of the cases were analyzed by statistical methods,therapeutic evaluation was conducted,and survival analysis and comparison were carried out by Kaplan-Meier method.Results:The median age of the 138 cases of patients was 76,and the pathological diagnosis of NSCLC was confirmed.The objective response rate of these patients was 29.7%,the disease control rate was 73.9%,and the median progression-free survival(PFS)of the whole group was 9.7 months(95%CI:8.878—10.522 months).Among the 138 cases of patients,102 cases had mutant epidermal growth factor receptor(EGFR),and 36 cases had unknown EGFR gene status.The objective response rate and disease control rate of the 102 patients with mutation were 37.25% and 81.37%,respectively,and the mPFS was 10.9months(95%CI:10.063-11.737 months).The objective response rate and disease control rate of the patients with unknown EGFR gene status were 8.33%and 52.78%,respectively,and the mPFS was 6.5 months(95%CI:5.913-7.087months).Among the 102 patients with mutation,59 patients took icotinib as firstline therapeutic regimen,and 43 patients took it as second-line or above therapeutic regimen.The mPFS of the first-line and second-line or above patients was 12.3 months(95%CI:11.453-13.147 months)and 8.8 months(95%CI:8.159-9.441 months),respectively.Among the 138 cases of patients included in this study,the most common adverse reactions were Grade I or II skin rashes and diarrhea,with 48 cases attacked by the former(34.8%)and 18 cases attacked by the latter(13.0%),no Grade III or above skin rashes occurred.Conclusion: 1.The curative effect of icotinib in treating elderly patients with NSCLC was equivalent to that in overall population with EGFR mutant in previous reports.2.Compared with the cytotoxic chemotherapy regimen,EGFR-TKI icotinib obtained more lasting tumor remission time in elderly patients with mutation.3.As to elderly patients with NSCLC,routine detection of EGFR gene mutation should be conducted before treatment,and icotinib in the treatment of patients with EGFR gene mutation can obtain higher remission rate.4.For patients with unknown EGFR status who cannot tolerate or are reluctant to chemotherapy,oral oral administration of icotinib for treatment can be considered.5.Icotinib has weak major adverse event and can be easily handled,and the drug tolerance is favorable.