Clinical Characteristics And Survival Analysis Of Patients With Advanced NSCLC With EGFR Mutation

Purpose:To retrospectively analyze the clinical data of patients with advanced non-small cell lung cancer(NSCLC)with Epidermal growth factor receptor(EGFR)mutation,and to study the different EGFR mutation status in patients with advanced NSCLC,clinical pathological features,and the effects of PFS.Method:1.Subjects:292 patients with EGFR mutation status were detected by ARMS,whose pathology was confirmed as non-small cell lung cancer during January 2016 to December 2017 in Shaanxi Cancer Hospital.Clinical characteristics and survival analysis of 198 patients with advanced stage ⅢB-Ⅳ who met the inclusion and exclusion criteria were analyzed.2.Information collection:1 gender,age,ECOG score,smoking status;2 pathological type;3 EGFR mutation status;4 first admission hematology(platelets,D-dimer),tumor markers(CEA,NSE,CYFRA21-1);5 TNM staging:6 first-line treatment,progression-free survival(PFS).3.Inclusion criteria:Complete treatment;phase ⅢB-Ⅳ;known EGFR gene status;NSCLC patients with evaluable lesions and no second primary tumor.4.Statistical methods:Statistical analysis was performed using SPSS 18.0 software.Correlation between variables was analyzed by chi-square test.Survival analysis was performed by Kaplan-Meier method.The Cox risk regression model was used for multivariate analysis of the selected prognostic factors.P<0.05 was statistically significant.Result:1.Correlation analysis of clinical features:(1)198 patients with advanced lung cancer:EGFR mutant was associated with female(p<0.001),non-smoking(p<0.001),adenocarcinoma(p<0.001),bone metastasis(p<0.001),abnormal CEA(p= 0.026).(2)Among 76 patients with EGFR mutations(19-Del mutation and L858R mutation)in patients with advanced NSCLC:L858R mutation was associated with abnormal CYFRA21-1 value(p=0.040)and D-dimer abnormality(p<0.001).(3)70 elderly patients aged 65 years and older:EGFR mutant and female(p=0.002),non-smoking(p=0.004),adenocarcinoma(p=0.004),bone metastasis(p=0.009),CYFRA21-1 normal(p=0.023),normal platelet count(p=0.011)2.Survival analysisProgression free survival PFS:Kaplan-Meier univariate analysis showed that the median OS of patients was associated with mutation status(mutant/wild type:6.0m/3.2m,p<0.001,the difference was statistically significant);treatment(targeted therapy/non-targeted therapy:6.3m/3.3m,p<0.001,The difference is statistically significant)relevant.There was no significant correlation with the remaining clinical pathological featuresConclusion:1.In patients with advanced NSCLC,EGFR mutations accounted for about 41%,of which 19-del and L858R mutations accounted for more than 90%of the total mutations2.In patients with advanced NSCLC,EGFR gene mutations are most common in women,non-smoking,adenocarcinoma,and bone metastases.In the subgroup analysis,the data of elderly patients were consistent with the overall,suggesting that there was no significant correlation between age and EGFR gene mutation3.Patients with advanced EGFR-sensitive mutations In patients with NSCLC,patients receiving EGFR-TKIs had a better first line mPFS than those without EGFR-TKIs.