易瑞沙治疗晚期肺腺癌临床观察.docVIP

易瑞沙治疗晚期肺腺癌临床观察 【摘要】 目的 观察易瑞沙治疗晚期肺腺癌的疗效及毒副反应。方法 对35例Ⅳ期经化疗失败的肺腺癌患者应用易瑞沙，每次250 mg，每天1次，口服，至病情进展。结果 35例患者中，CR 2例，PR 12例，有效率43.6%;不吸烟者CR 2例，吸烟者CR 0例，PR 2例，差异有显著性(P=0.04);男性CR 0例，PR1例，女性CR 2例，PR 11例，差异有显著性(P=0.038)。24例出现皮肤改变，7例有轻度腹泻，无需停药。1例CR和2例PR患者在服药11个月和12个月后出现复发和新病灶。结论 易瑞沙能有效缓解晚期化疗失败的肺腺癌不吸烟女性患者的病情，毒副反应可以耐受。但长期服用易瑞沙可能出现耐药。 【关键词】 肺腺癌; 易瑞沙; 毒副反应; 治疗结果 　　【Abstract】 Objective To observe the effects of iressa in the treatment of advanced lung adenocarcinoma and its toxicity reaction.Methods Iressa was administered to 35 phase II patients with lung adenocarcinoma who failed in the chemotherapy, each with 250mg, oral, once a day, until progress of the disease.Results Of all the 35 cases, there were 2 cases of CR, 12 cases of PR. The efficiency rate was 43.6%. Furthermore, 2 cases of CR and 10 cases of PR occurred in nonsmokers while no case of CR and 2 cases of PR in smokers. The difference was statistically significant (P=0.04). There was no case of CR and 1 case of PR in the males and 2 cases of CR and 11 cases of PR in the females, which also indicated remarkable difference (P=0.038). 24 cases developed skin changes and another 7 cases mild diarrhea, with no drug withdrawal followed. Recurrence and new lesions occurred in 1 case of CR and 2 cases of PR 11 months and 12 months respectively after drug administration.Conclusion Iressa can effectively relieve the condition of the nonsmoking female patients with advanced lung adenocarcinoma who failed in chemotherapy. Its toxicity is tolerable. But longterm use may lead to drug resistance. 　　【Key words】 Lung neoplasm; Iressa; Toxicity reaction; Treatment outcome 　　肺癌是发病率和死亡率增长最快、对人类健康和生命威胁最大的恶性肿瘤[1]。尽管医学技术的不断发展及许多新化疗药物的出现，肺癌的疗效仍不尽人意。分子靶向治疗近年来在肿瘤治疗领域成就突出。易瑞沙是表皮生长因子受体酪氨酸激酶抑制剂，因其对肿瘤作用特异，不良反应小，在一部分非小细胞肺癌上显示了很好的疗效。本文总结了应用易瑞沙治疗肺腺癌这一特殊群体的经验，报告如下。 　　1 资料与方法 　　1.1 一般资料 2007年2月～2009年5月我科共收治35例用易瑞沙治疗后可随访的肺腺癌患者，所有患者均有病理组织学诊断，均为Ⅳ期。其中，不吸烟14例，吸烟21例，至少接受过大于1周期化疗者为23例，未化疗患者12例(均为不愿意或不能耐受化疗者)，所有患者均为可测量病灶。 　　1.2 治