Maojing Guan¹, Qingming Shi¹, Yong Wang², Congjing Xu³, Xianping Cheng⁴, Kangsheng Gu⁵, Lijuan Peng⁶, Minghong Bi⁷, Dongsheng Pang⁸, Hui Liang⁹, Lei Tang⁴, Hesheng Qian¹⁰,  Guangming Wang¹⁰, Xiang Sun¹¹, Maojing Guan¹

¹Oncology, Anhui chest hospital, ²Oncology, Anhui province hospital, ³Oncology, Huainan East Hospital, ⁴Oncology, No2.anhui province hospital, ⁵Oncology, The First Affiliated Hospital of Anhui Medical University, ⁶Oncology, No.1 hospital of hefei, ⁷oncology, The First Affiliated Hospital of Benbo Medical University, ⁸Oncology, No.116 hospital of anqing city, ⁹Oncology, Chinese tradtional hospital of luan city, ¹⁰Oncology, Fuyang Cancer Hospital, ¹¹Oncology, No.1 hosptial of hefei city.

Objective:To assess differences in overall survivalamong patients with NSCLC using TKIs in first or second line treatmentand different TKIs. 

Method: Collecting patients’ data in CRF anduse SPSS software for statistical analysis. 

Result: 463 patients arefrom 16 hospitals in which 212 cases is male and 252 cases is female, with amedian age of 62 (22-93) years. Pathological types: adenocarcinoma 340 cases,48 cases of squamous cell carcinoma, large cell carcinoma 4 cases, 35 cases ofundifferentiated and other types of 26 cases. GFR mutation test: a totalof 130 cases were detected, the detection rate of 28.1%, of which 11 cases ofwild-type and 119 cases were mutant. Stage: IIIa of the nine cases, IIIb of 48cases, IVa of 152 cases, and IVb of 243 cases. Treatment: 37.1 % (172 cases)using TKIs as first-line treatment while 47.5% (220 cases) using TKIs as second-linetreatment and 14.4% (67patients) in three-line treatment. The median age offirst-line and second-line are respectively 68 (34-93) and 59 (22-85) years, P=0.000;and the two groups have no difference in KPS score before treatment (P=0.307).68% of all patients are adenocarcinoma in first-line group while 81.8% insecond-line group and the difference is meaningful (P=0.001). One yearoverall survival rate of first and second-line group are 20.4% versus 28.8%while two-year overall survival was 5.7 versus 11.1%, and the comparisonbetween the two is statistically significant (P=0.04). Survival: Of allpatients using TKI drugs 1, 2, 3 year(s) survival is respectively 56.2%, 27.9%,17.3%; of patients using gefitinib is 62%, 31.9%, 20.4%; of patients usingerlotinib is 63.2%, 29.5%, 18.5%; of patients using icotinib is 39.8%, 20%,11.7%. 

Conclusion: 1. In this survey of patients, the overall survivalof patients using TKIs as first-line treatment is inferior compared withsecond-line owing to older patients and the low proportion of adenocarcinoma.2. The survival benefit is clearer in erlotinib and gefitinib than icotinib.

Key Words: lung cancer  Tyrosine kinase inhibitor  Survival analysis