Evaluation Of Clinical Efficacy Of Gefitinib In Patients With Advanced Lung Adenocarcinoma And Analysis Of Influencing Factors

ObjectiveFollowing a retrospective analysis of the short-term efficacy,adverse reaction rate and progressive-free survival(PFS)of gefitinib and pemetrexate combined with platinum in the Progression of advanced lung adenocarcinoma,it is necessary to explore how to choose the most appropriate treatment options and achieve the maximum benefit in patients with advanced lung adenocarcinoma.MethodsSelection of the first affiliated hospital of zhengzhou university from January 2015 to January 2017 in early treated 200 cases of patients with advanced lung adenocarcinoma as the research object,200 patients meet the Epidermal growth factor receptor(Epidermal growth factor receptor,EGFR)genetic testing for 19 exons deletion or exon 21 L858 R point mutations,divided into two groups,group a: a total of 110 cases,the treatment of oral;Group b: 90 patients were treated with pemetrexed combined with platinum-based chemotherapy.The relevant factors affecting the short-term Response rate(RR)of patients in group a were analyzed,and the short-term efficacy,incidence of adverse reactions and PFS differences between patients in groups a and b were compared.Results(1)influencing factors of short-term efficacy RR in group a: the treatment RR of 110 patients was 34.55%(38/110).Further analysis showed that RR was correlated with gender(male/female),tumor stage(IIIB/IV),bone metastasis,and tumor diameter(3cm/ > 3cm),with statistically significant difference(P < 0.05).It had nothing to do with the patient's age,the score of the Eastern Cooperative Oncology Group(ECOG),smoking history,brain metastasis,adrenal metastasis or liver metastasis(P > 0.05).Logistic regression analysis showed that male and stage IV patients were independent risk factors affecting RR of short-term efficacy of gefitinib(P < 0.05).(2)Comparison of short-term efficacy between the two groups: there was no statistically significant difference in RR between groups a and b(34.55% vs.33.33%,P=0.498).There was no significant difference in Disease control rate(DCR)between groups a and b(86.36% vs.78.89%,P=0.113).(3)Comparison of adverse reactions between the two groups: the most common adverse reaction in group a was skin rash,with an incidence of 38.18%(42/110),followed by diarrhea,with an incidence of 18.18%(20/110).Group b is the most common adverse reactions in bone marrow suppression,the incidence was 75.56%,including ? 30 patients(33.33%),? degrees 25 cases(27.78%),? ~ ? degrees 13 cases(14.44%),gastrointestinal adverse reaction is mainly characterized by nausea,vomiting,rate of 51.11%.(4)comparison of PFS between the two groups: the median PFS in group a was better than that in group b,and the difference was statistically significant(8.2 months vs.5.8 months,P < 0.001).From the overall PFS comparison between the two groups,the PFS of group a was still higher than that of group b,and the difference was statistically significant(P < 0.001).ConclusionsGefitinib is suitable for the treatment of advanced lung adenocarcinoma patients with EGFR gene mutation,especially for women and stage IIIB patients,with a high therapeutic efficiency.Gefitinib monotherapy has a considerable short-term efficacy compared with traditional pemetrexate combined with platinum chemotherapy,which can improve the progressionless survival period with fewer adverse reactions,and is suitable as the preferred treatment for patients with partial advanced lung adenocarcinoma.