Kết quả điều trị ung thư phổi biểu mô tuyến di căn não có đột biến EGFR bằng thuốc ức chế Tyrosine kinase (TKIs)=Treatment outcomes of patients with brain-metastatic, EGFR-mutated lung adenocarcinoma using Tyrosine kinase inhibitors (TKIs)

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Tác giả: Thị Lệ Quyên Lê, Thị Hồng Quỳnh Mai, Thị Thảo Nịnh, Ngọc Nam Phùng

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.45727

Bộ sưu tập: Metadata

ID: 478097

Thêm vào giỏ

Đánh giá kết quả điều trị ung thư phổi (UTP) biểu mô tuyến di căn não có đột biến EGFR bằng thuốc TKIs và một số yếu tố liên quan đến PFS. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả cắt ngang tiến hành trên bệnh nhân UTP biểu mô tuyến di căn não có đột biến EGFR (Del exon 19 hoặc L858R exon 21) được điều trị bằng thuốc ức chế Tyrosine kinase có kết hợp với xạ toàn não hoặc gamma knife hoặc không tại bệnh viện Ung Bướu Hà Nội từ tháng 01/2018 đến 6/2023. Kết quả: Có 46 bệnh nhân tham gia nghiên cứu, tuổi trung bình 55 ± 10,6
tỷ lệ nam/nữ là 1,3/1. Đột biến Del exon 19 hay gặp hơn, ở 30 bệnh nhân chiếm 65,2%. Đáp ứng một phần đạt được ở 30 (65,2%) bệnh nhân
tỷ lệ kiểm soát bệnh đạt 93,5%. Trung vị thời gian sống thêm không bệnh tiến tiển (PFS) là 11,5 tháng. Trung vị PFS tại tổn thương di căn não là 11 tháng. Trung vị PFS ở BN có đột biến exon 19 và exon 21 là 13,7 tháng và 8,0 tháng, sự khác biệt có ý nghĩa thống kê với p<
0,05. Trung vị PFS của nhóm có 1-3 ổ di căn não và >
3 ổ di căn não là 12,5 tháng và 8,0 tháng, sự khác biệt không có ý nghĩa thống kê với p>
0,05. Không có sự khác biệt về PFS giữa điều trị TKI đơn thuần và kết hợp với xạ trị tại não. Kết luận: Điều trị thuốc TKIs trên bệnh nhân UTP biểu mô tuyến di căn não mang lại tỷ lệ đáp ứng toàn thể cũng như đáp ứng tại não cao, kéo dài thời gian sống thêm bệnh không tiến triển.To evaluate the treatment outcomes of patients with brain-metastatic, EGFR-mutated lung adenocarcinoma treated with TKIs (Tyrosine kinase inhibitors), and factors associated with their progression-free survival (PFS). Subjects and Methods: A cross-sectional descriptive study was conducted on patients with EGFR-mutated (Del exon 19 or L858R) lung adenocarcinoma with brain metastases, treated with TKIs, either combined with whole-brain radiotherapy or gamma knife, or without radiotherapy at Hanoi Oncology Hospital from January 2018 to June 2023. Results: 46 eligible patients were enrolled. Their average age was 55 ± 10.6 years
the male/female ratio was 1.3:1. The Del exon 19 mutation was more common, found in 30 patients (65.2%). Partial response was achieved in 30 patients (65.2%), with a disease control rate of 93.5%. The median PFS was 11.5 months. The median PFS for patients with brain metastases was 11 months. The median PFS for patients with exon 19 and exon 21 mutations was 13.7 months and 8.0 months, respectively, with a statistically significant difference (p<
0.05). The median PFS for patients with 1-3 brain metastases and those with more than 3 brain metastases was 12.5 months and 8.0 months, respectively, but the difference was not statistically significant (p>
0.05). There was no difference in PFS between patients treated with TKIs alone and those treated with a combination of TKIs and brain radiotherapy. Conclusion: Treatment with TKIs in lung adenocarcinoma patients with brain metastases provides a high ORR and brain response, and prolong PFS.

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