PURPOSE:The epidermal growth factor receptor inhibitors, gefitinib and erlotinib, are used as standard salvage therapy for advanced non-small-cell lung cancer (NSCLC). The aim of the present study was to compare their efficacies in this population. PATIENTS AND METHODS:The Taiwan Cancer Registry and the National Health Insurance claim databases were searched for newly diagnosed patients with NSCLC from 2004 to 2007 who received gefitinib or erlotinib as third-line therapy. Overall survival (OS) and time to treatment failure (TTF) were determined from registered parameters. Treatment efficacies were compared by the log-rank test in total population and subsets with different clinical characteristics. The Cox's proportion hazard model was used to estimate the adjusted hazard ratios in multivariate analyses. RESULTS:A total of 984 patients who received gefitinib (67%) or erlotinib (33%) were included. Patients receiving gefitinib or erlotinib had similar OS (median, 10.2 versus 9.9 months, p=0.524) and TTF (median, 5.5 versus 3.4 months, p=0.103). In multivariate analyses, both treatment groups had similar risk of overall mortality (adjusted hazard ratio [HR]=1.04, p=0.629) and treatment failure (adjusted HR=0.94, p=0.417). Comparing the treatments in subgroups based on age, tumour histology and gender also revealed no differences in OS and TTF. For patients who received gefitinib or erlotinib for more than 3 or 6 months, there was no difference in TTF but patients who received erlotinib had longer OS. CONCLUSIONS:Gefitinib and erlotinib had similar efficacies as salvage therapy for advanced NSCLC in Taiwan.

译文

目的:表皮生长因子受体抑制剂吉非替尼和厄洛替尼被用作晚期非小细胞肺癌(NSCLC)的标准挽救疗法。本研究的目的是比较他们在这一人群中的疗效。
病人和方法:在台湾癌症登记处和国家健康保险索赔数据库中搜索2004年至2007年新诊断的接受吉非替尼或厄洛替尼作为三线治疗的非小细胞肺癌患者。根据注册参数确定总生存期(OS)和治疗失败时间(TTF)。通过对数秩检验比较总人口和具有不同临床特征的亚组的治疗效果。使用Cox比例风险模型估算多元分析中调整后的风险比率。
结果:共纳入984例接受吉非替尼(67%)或厄洛替尼(33%)治疗的患者。接受吉非替尼或厄洛替尼的患者的OS(中位10.2对9.9个月,p = 0.524)和TTF(中位5.5对3.4个月,p = 0.103)相似。在多变量分析中,两个治疗组的总死亡率(调整后的危险比[HR] = 1.04,p = 0.629)和治疗失败(调整后的HR = 0.94,p = 0.417)的风险相似。根据年龄,肿瘤组织学和性别对亚组的治疗方法进行比较,还发现OS和TTF均无差异。对于接受吉非替尼或厄洛替尼治疗超过3或6个月的患者,TTF没有差异,但接受厄洛替尼的患者的OS更长。
结论:吉非替尼和厄洛替尼的疗效与台湾晚期NSCLC的挽救疗法相似。

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