A Real World Study On EGFR Mutation Status And Prognostic Factors Of Non-small Cell Lung Cancer In Hainan

Objective: Using the real world study(RWS),we retrospectively analyzed the relationship between epidermal growth factor receptor(EGFR)mutations and clinical characteristics of non-small cell lung cancer(NSCLC)in Hainan,and analyzed the prognosis factors of patients in the stage III-IV.Methods: 1.The study subjects were 223 patients with NSCLC in hainan,including 68 patients stage III-IV initial treatment or first relapse after surgery.2.The correlation between EGFR gene mutation and clinical characteristics was analyzed by chi-square test,and the independent affecting factors of EGFR gene mutation were analyzed by binary Logistic regression model.3.Clinical information of 68 patients with stage III-IV initial treatment or first recurrence after operation were collected,and evaluate the efficacy according to ECTST criteria;Kaplan-Meier method was used for survival analysis,Log rank test was performed between groups,and Cox model was used for multi-factor analysis.Results: Of the 223 subjects,104(46.6%)had EGFR gene mutation.The mutation rate of EGFR gene in female and non-smoking patients is higher than that in male and smoking patients(all P< 0.05).However,there was no significant correlation between EGFR gene mutation and age,pathological type,clinical stage,alcohol consumption,lymph node metastasis and distant metastasis.Logistic regression analysis did not find the influencing factors of EGFR mutation.Survival analysis of 68 patients with initial treatment or first postoperative recurrence of III-IV:kaplan-meier univariate analysis showed that the median PFS(10.0 months)in the first-line oral EGFR-TKIs group or the median PFS(13.3 months)in the oral EGFR-TKIs combined chemotherapy group was significantly higher than that in the chemotherapy group(6.0 months,P < 0.05).The median PFS(10.0 months)of the non-bone metastases group was significantly higher than that of the bone metastases group(6.0 months,P < 0.05).There was no significant correlation between the clinical characteristics and the first-line PFS.Cox multivariate analysis results showed that first-line treatment and combined bone metastasis were independent factors affecting median PFS in first-line treatment.The median first-line treatment PFS of patients with 19-Del mutation was extended by 4.0 months compared with those with 21L858R mutation(P > 0.05).Conclusions: In this study,the EGFR mutation rate of non-small cell lung cancer was 46.6%,and 19-Del mutation and 21L858R mutation were the most common.EGFR gene mutation in NSCLC patients in hainan was basically the same as in other regions in china.In advanced NSCLC,primary treatment with bone metastasis is a prognostic risk factor,and EGFR-TKIs treatment is a prognostic protective factor,which is consistent with other regions in china.