Abstract：Objective: To investigate the efficacy of gefitinib targeted therapy combined with chemotherapy in patients with advanced non-small cell lung cancer (NSCLC) and to analyze the predictors of progression-free survival (PFS).Methods: The clinical data of 255 patients with advanced NSCLC who were diagnosed and treated in the hospital were retrospectively analyzed from January 2019 to December 2021. The above subjects were divided into control group (n=78) and combined group (n=177) by the treatment methods. The control group was treated with conventional chemotherapy, while the combined group received gefitinib targeted therapy combined with chemotherapy. The short-term efficacy was compared between the control group and the combined group. Kaplan-Meier was used to draw the PFS survival curve of the two groups to evaluate the long-term efficacy. Univariate analysis and multivariate COX regression analysis were used to analyze the predictors of PFS in the combined group.Results: Compared with the control group, the objective response rate (ORR) (68.36% vs 55.13%) and disease control rate (DCR) (97.14% vs 87.18%) in the combined group were higher (P<0.05). The median PFS in the combined group was 14 months and that in the control group was 9 months. Log-rank test revealed that the survival curve in the two groups was different (95%CI: 1.12~2.17, Log-rank test χ2=7.624, P=0.006). Univariate analysis suggested that age, pleural effusion, bone metastasis, epidermal growth factor receptor (EGFR) mutation, tumor staging, tumor diameter, lactate dehydrogenase (LDH) level and short-term efficacy were correlated with PFS (P<0.05). Multivariate COX regression analysis revealed that pleural effusion (95%CI: 1.025~1.166), EGFR mutation (95%CI: 1.018~1.067), tumor stage IV A-IV B (95%CI: 1.021~1.140), tumor diameter≥5cm (95%CI: 1.039~1.159), LDH > 245U/L (95%CI: 1.055~1.150) and optimal efficacy (95%CI: 1.548~4.752) were independent predictors of PFS (P<0.05).Conclusion: Gefitinib targeted therapy combined with chemotherapy has a good short-term effect in the treatment of advanced NSCLC, and can effectively improve the long-term prognosis of patients. Pleural effusion, tumor staging, tumor diameter, LDH level and optimal efficacy are independent predictors of PFS in patients with advanced NSCLC receiving gefitinib targeted therapy combined with chemotherapy.
2024, Vol. 30 
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