| Objective:To studied the efficacy of chemotherapy and EGFR-TKI against CTC counts in NSCLC;To studied the efficacy of EGFR-TKI against CTC’ EGFR Expression in NSCLC.Methods:86 patients’ detail clinical information who received first-line chemotherapy and 66 patients’ information who received first-line EGFR-TKI between September 1,2013 to March 31,2016,about age,gender,PS score,pathological type,degree of differentiation,clinical stage were screened from the hospital information data base of the Third Affiliated hospital of Kunming Medical University by the settings of inclusion criteria and exclusion criteria.The inclusion criteria include stage Ⅲb or ⅣNSCLC,aged>18 years old,PS 0-3,life expectant more than 3 months,there are available for assessment of the lesions.The counts of CTC and the expression level of EGFR were determined by flow cytometry.According to the RECIST standard to evaluate the efficacy and telephone follow up were done to obtain the survival information of all patients.After that,all patients’ data were processed by IBM(?)SPSS(?)version 16.0.Results:In the aspect of chemotherapy patients,the low CTC counts group had a RR of 47.9%(23/48)and a DCR of 72.9%(35/48);The high CTC counts group had a RR of 31.5%(12/38)and a DCR of 57.8%(22/38)(P=0.003).After chemotherapy,CTC counts was reduced from19.8±8.1/7.5ml t0 13.3 ± 5.6/7.5ml in the effective treatment of patients(P=0.013);The patients with ineffective treatment was changed from 18.3±8.6/7.5ml to 17.6±7.5/7.5ml(P=0.076).The median OS of low CTC counts group and high CTC counts group was 16.5 months(95%CI:10.1-38.5months)and 10.3 months(95%CI:7.9-37.2months),respectively(P=0.0 1).The median PFS was 6.1 months(95%CI:3.8-9.6 months)and 3.2 months(95%CI:1.5-7.8months),respectively(P=0.005).In the aspect of EGFR-TKI patients,the low CTC counts group had a RR of 47.4%(18/38)and a DCR of 68.4%(26/38).The high CTC counts group had a RR of 28.6%(8/28)and a DCR of 50%(14/28)(P=0.021).After EGFR-TKI treatment,CTC counts was reduced from 19.3±8.1/7.5ml to 12.1±3.9/7.5ml in the effective treatment of patients(P=0.011);The patients with ineffective treatment was changed from 22.5±8.3/7.5ml to 21.3±9.5/7.5ml(P=0.083).The median OS of low CTC counts group and high CTC counts group was 21.8 months(95%CI:10.1-39.5months)and 15.8months(95%CI:7.5-38.1months),respectively(P=0.003).The median PFS was 10.6 months(95%CI:6.1-15.8 months)and 5.3 months(95%CI:1.1-13.5months),respectively(P=0.001).The high EGFR expression group had a RR.of 53.3%(16/30)and a DCR of 68.4%(24/30).The low EGFR expression group had a RR of 27.8(10/36)and a DCR of 44.4%(16/36)(P=0.003).After EGFR-TKI treatment,EGFR expression level was reduced from 28.8±15.7/7.5ml to 13.9±9.1/7.5ml in the effective treatment of patients(P=0.013);The patients with ineffective treatment was changed from 19.7±16.9/7.5ml to 20.3±15.8/7.5ml(P=0.075).The median OS of high EGFR expression group and low EGFR expression group was 23.6months(95%CI:9.3-39.5months)and 14.5months(95%CI:7.5-37months),respectively(P=0.007).The median PFS was 11months(95%CI:6.1-15.8months)and 4.5months(95%CI:1.1-13.5months),respectively(P=0.001).Conclusion:1.The CTC counts can be used as an index predicting the chemotherapeutic effect of advanced NSCLC patients.The chemotherapeutic effect was negatively correlated with the CTCs counts.Dynamic change of the CTC counts can be an effective index to evaluate chemotherapeutic effect.Meanwhile,the CTC counts was negatively correlated with the prognosis of advanced NSCLC patients.The change of CTC counts can be used as an index evaluating the prognosis of advanced NSCLC patients.2.Efficacy and prognosis of EGFR-TKI treatment and CTC counts were negatively correlated,and CTC counts could be used to predict efficacy of EGFR-TKI treatment and prognosis of advanced NSCLC.3.Efficacy and prognosis of EGFR-TKI treatment and EGFR expression level were positively correlated,and could be used to predict efficacy of EGFR-TKI treatment and prognosis of advanced NSCLC. |
PDF Full Text Request