Efficacy Of Chemotherapy And Oral Epidermal Growth Factor Receptor-tyrosine Kinase Inhibitor In Lung Adenocarcinoma

BackgroundNon-small cell lung cancer(NSCLC)is one of the most common malignancies in the world,and its mortality rate has been on a global upward trend.The initial clinical manifestations of lung cancer patients are not typical compared with other respiratory diseases.Many patients suffer hemoptysis and chest tightness and then go to the hospital for treatment.The disease may have been severely advanced and the surgical opportunity has been lost.This is based on drugs.The comprehensive treatment model has become the key to treatment.In 2002,the NCCN Clinical Practice Guidelines for Oncology clearly pointed out that the platinum-based combination of the two drugs has obvious advantages in the first-line treatment of advanced NSCLC.Afterwards,the first-ever chemotherapeutic drugs continued to appear,and the side effects continued to decrease,establishing chemotherapy based on third-generation chemotherapy drugs.As the genes and signal transduction research,molecular targeted therapy for the treatment of malignant tumor provides a new train of thought..The earliest and most profound research on NSCLC was the epidermal growth factor receptor(EGFR)gene.Its discovery made the treatment of lung adenocarcinoma enter the era of molecular targeting.On this basis,one generation of epidermal growth factor receptor-tyrosine kinase inhibitor(EGFR-TKI)that have been marketed in succession includes: Gefitinib,Erlotinib,and Icotinib.In this study,progression-free survival(PFS)as the main observation index comparing the first generation of EGFR-TKI and pemetrexed-based platinum-containing drugs as the first-line treatment program for the treatment of advanced lung adenocarcinoma.PurposeTo investigate the efficacy of oral first-generation EGFR-TKI and platinum-containing bispyridam for advanced lung adenocarcinoma in the first-line treatment? Objects and methodsA retrospective study of 161 patients who met the inclusion criteria at the First Affiliated Hospital of Zhengzhou University from July 1,2016 to March 31,2017 was divided into oral EGFR-TKI group and chemotherapy group.The recent curative effect was based on the RECIST 1.1 standard for accurate clinical evaluation.The efficacy can be divided into complete remission(CR),partial remission(PR),and disease stabilization(SD)and disease progression(PD).Long-term efficacy was observed with progression-free survival(PFS).Using SPSS18.0 software,the chi-square test was used to analyze the count data,the Kaplan-Meier method was used to calculate the mPFS and the survival curves were plotted,and the differences were analyzed using the Log-rank method.The efficacy of EGFR-TKI and chemotherapy as first-line treatment regimens for advanced lung adenocarcinoma was found to be different.Test level is ?=0.05 ResultA total of 161 chemotherapy patients were collected in this study.The general situation is shown in the table below.A total of 125 patients were found in the oral EGFR-TKI alone group,of whom 68.8% were common in women,and the average age was 56.36 years.There were 35.7% of bone metastases,68.2% of brain metastases,and 80% of lymph node metastases.A total of 36 patients were included in the study,63.9% of whom were women;the average age was 59.34 years,61.8% of bone metastases occurred,26.5% of brain metastases occurred,and 83.3% of lymph node metastases occurred;there was no statistical difference between the groups.In terms of short-term efficacy,CR,PR,SD,and PD were evaluated 3 months after treatment.The DCR rates in group A and B were 92% and 83.33%,respectively,using a calibrated chi-square test,P> 0.05,the difference was not statistically significant,it can be considered the same effect of the two groups in the near future.In terms of long-term efficacy,compared with the two groups of progression-free survival analysis,the mPFS in the chemotherapy group was 7.378(5.356-9.399)months;the oral EGFR-TKI alone was 11.416(10.406-12.427)months.Between the two groups,P<0.05 There were differences between the two groups of mPFS.Oral EGFR-TKI alone was superior to chemotherapy in long-term progression-free survival.ConclusionIn patients with lung adenocarcinoma with positive EGFR gene,oral targeting drug alone or pemetrexed-based chemotherapy has no obvious advantage in recent earnings.Targeted drug group can effectively improve patients' progression-free survival in the long term.