| background and purpose In recent years,epidermal growth factor receptor tyrosine kinase inhibitors(EGFR-TKIs)have got more curative effect in non-small cell lung cancer,and have been treated as a first-line treatment for non-small cell lung cancer patients with EGFR mutation.But almost all patients have disease progression after a period of time,producing acquired resistance.In this article,non-small cell lung cancer patients with icotinib resistance were divided into two groups,one group use pemetrexed combined platinum chemotherapy,and the other group use pemetrexed combined platinum while continuing to oral icotinib,comparing the clinical efficacy of the two groups and analyze the therapeutic effect of different people.Methods 1.This study collected all the patients in the second affiliated hospital of anhui medical university hospital from January 1,2013 to December 31,2016,all patients were diagnosed by histology and cytology clear for non-small cell lung cancer,cancer stage of the patients were ?B-?,the target lesions could be evaluated objectively,all patients with icotinib resistant,disease alleviate more than 3 months,the tumor would progress if continue to take icotinib,analysis of patients' clinical information,and the therapeutic effects of different treatment regimens were analyzed.2.Randomly divided into chemotherapy group and combining group,23 cases in the chemotherapy group used pemetrexed combining cisplatin(AP),witch had a total of four courses of chemotherapy,for pemetrexed 500 mg/m2,cisplatin,80 mg/m2,static,21 days for a cycle.23 patients in combining group except using the above AP chemotherapy for sequential take icotinib,A week after the end of chemotherapy,taking icotinib from that day until the next chemotherapy,a total of four courses.Results The PFS and OS in the chemotherapy group and the combining therapy group were 5.7 months VS.6.9 months and 19.4 months VS.18.7 months,and there were no statistically significant difference between the two groups(P>0.05).The ORR in the chemotherapy group and the combining therapy group were 43.5% VS.34.8%,and the DCR in the two groups were 86.9% VS.95.7%(P>0.05).The PFS in smoker and non-smoker of receiving the first Icotinib treatment were 5.8 months VS.9.8 months(P=0.01).There was not much to do with curative effect of the chemotherapy group with Icotinib resistance and smoking or sex(P>0.05).The OS and PFS in non-smokers and smokers of the combining therapy group with Icotinib resistance were 4.8 months VS.8.3 months(P=0.004)and 13.0 months VS.22.3 months(P=0.017).The OS and PFS in men and women of the combining therapy group with Icotinib resistance were 5.3 months VS.8.2 months(P=0.041)and 13.7 months VS.22.5 months(P=0.023).There was not much to do with curative effect of the two treatments with Icotinib resistance and age or resistant time for the first stage.(P>0.05).Conclusions 1.There was no significant effect on the efficacy about whether use icotinib in patients with advanced non-small cell lung cancer.2.The efficacy of smoking patients was similar to non-smokers in chemotherapy group n the treatment group was comparable with that of non-smokers,and Non-smoking patients had better progression free survival and overall survival than smokers in the combining group after drug resistance.3.The gender of chemotherapy group had no obvious effect on the treatment effect,and the female patients in combination group the had better efficacy than the male patients.4.The age of non-small cell lung cancer patients and the duration of the first-line targeted drug resistance had no significant effect on the efficacy of chemotherapy or chemotherapy combined with chemotherapy after drug resistance. |
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