Recurrence Pattern Of Advanced Non-small Cell Lung Cancer Treated With Gefitinib

Objective:Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) such as gefitinib is well used in advanced non-small cell lung cancer (NSCLC). However, there are incomplete data about the survival and recurrence place in patients whose disease progressed after gefitinib treatment.Patients and Methods:We retrospectively studied the316patients with stage Ⅲ/Ⅳ NSCLC treated with gefitinib. First recurrence place and clinical features that impacted recurrence and survival were evaluated.Results:The median progress free time and survival time were238days and468days. The median survival time after progression was145days. The most common places of recurrence and median progress free time were as follow:lung (62.34%,198days), bone (17.72%,347days), centre nerve system (16.14%,248days), liver (9.49%,235days), adrenal gland, abdomen, subcutaneous and others (7.19%,231days). The first recurrence places were related with prior lesion. The median survival times after progression were as follow:lung147days, bone138days, centre nerve system157days, liver70days, adrenal gland, abdomen, subcutaneous and others114days. And the median survival times after progression in single or multiple organ metastases were170days and98days respectively. The survival after recurrence was significantly affected by liver metastasis and multiorgan metastasis. Treatment after progression included best supportive care (BSC), continuous EGFR-TKIs therapy, chemotherapy, radiotherapy, and retreatment with EGFR-TKIs. Median survival time after progression in patients received, chemotherapy, radiotherapy and EGFR-TKIs were longer than BSC (P<0.05).Conclusions:Our data suggest that patients who received gefitinib should be paid more attention to lung and previous metastasis during follow up. Liver metastasis, number of metastasis and treatment after progression of disease were prognostic factors. After failed with gefitinib treatment patients may benefit from radiotherapy, chemotherapy and continuous EGFR-TKI therapy and retreatment of EGFR-TKIs.