| Objective: To investigate the therapeutic effects and safety of icotinib versus combination of icotinib and chemotherapy drugs for the lung cancer(NSCLC)patients with EGFR mutation-positive and recurrence.Methods: The data of 120 patients,including in-patients and out-patients,with EGFR mutation-positive NSCLC and recurrence in the first affiliated hospital of Hebei Northern University were collected.All the patients were divided into 2 groups according to the treatment.The patients in icotinib group(n=60)were given icotinib only,and the patients in combination group(n=60)were treated with icotinib and chemotherapy drugs.The therapeutic effects including the short-term,long-term and adverse effects were counted and analyzed.Results: Comparing the short-term efficacy after two cycles of treatment in the combination group and the icotinib group,it was found that the objective response rate was 38.3%(23/60 cases)and 36.7%(22/60cases)in these two groups.There were no statistical differences between the two groups(P>0.05);the clinical benefit rate of the combination group and the icotinib group was 96.7%(58/60 cases)and 93.3%(56/60 cases),respectively.(P>0.05).By comparing the improvement of clinical symptoms of two groups of patients after one-cycle treatment,the total scores of clinical symptoms before and after one cycle of treatment in the combination group were 6.21 ± 3.36 and 2.26 ± 1.72,respectively.The scores in icotinib group were 6.57 ± 2.97 and 2.68 ± 1.93.There were significant differences(P <0.05),indicating that after treatment,the typical clinical symptoms of the two groups of patients were significantlyimproved.However,there was no statistical difference between the two groups by paired t test(P> 0.05).At the level of tumor markers in the two groups,CEA,CA125 and CYFRA21-1 before treatment in the combination group were(21.36 ± 8.45 ng / m L),(40.21 ± 4.39 u / m L),and(7.55 ± 2.53 ng / m L),After treatment,they were(9.25 ± 4.478 ng / m L),(26.51 ± 7.25 u / m L),and(1.76 ± 0.65 ng / m L),and the differences were statistically significant(P <0.05).CEA,CA125,and CYFRA21-1 were(25.36 ± 4.78 ng / m L),(40.35 ± 7.54 u / m L),and(8.85 ± 4.21 ng / m L)before treatment in the icotinib group,and were(10.43 ± 3.27 ng / m L),(36.55 ± 3.31 u /m L)and(1.54 ± 0.55 ng / m L)after treatment,the difference was statistically significant(P <0.05).Comparing the survival of PFS and OS in the combination group and icotinib group,the median PFS of the combination group and icotinib group were 15.3 months and 10.2 months,respectively.COX regression analysis found that(HR=0.61,95% CI:0.41～0.84,P <0.05);the median OS of the combination group and the icotinib group were 32.3 months and 28.3 months,respectively.Multivariate COX regression analysis found that(HR=0.69,95% CI:0.51～0.91,P <0.05).Adverse reactions occurred in both groups after treatment.Adverse reactions in the combination group occurred in hematological toxicity,liver and kidney damage,and systemic symptoms.Adverse reactions in the icotinib group were mainly concentrated in non-hematological toxicity.The incidence of adverse reactions was statistically higher than that of the icotinib group,and the difference was statistically significant(P <0.05)..Conclusion: For patients with non-small cell lung cancer(EGFR mutation)that has relapsed after surgery,the clinical efficacy of icotinib combined with chemotherapy is significantly better than that of icotinib monotherapy,which can significantly prolong the patient’s PFS and OS.In terms of safety,the incidence of adverse reactions after combined chemotherapy has increased significantly,but can be tolerated aftercorresponding treatment,which should be taken seriously and evaluated clinically. |
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