吉非替尼治疗34例晚期非小细胞肺癌临床观察.docVIP

吉非替尼治疗34例晚期非小细胞肺癌临床观察 　　[摘要] 目的:探讨晚期非小细胞肺癌(NSCLC)患者应用吉非替尼治疗的效果及毒副作用。方法:34例经放化疗失败的非小细胞肺癌晚期患者,均发生远处转移。口服吉非替尼250 mg/次,每天1次,服药中位时间为4个月。结果:34例晚期NSCLC患者,无一例完全缓解(CR),19例部分缓解(PR),10例稳定(SD),5例进展(PD),全组有效率(CR+PR)为55.9% ,临床获益率(CR+PR+SD)为85.3%。中位生存期5.6个月,1年生存率为47.1%(16/34)。结论:吉非替尼治疗晚期NSCLC的疗效较好,毒副作用较轻,可以耐受。 　　[关键词] 非小细胞肺癌;吉非替尼;靶向治疗;表皮生长因子受体 　　[中图分类号] R734.2[文献标识码]B [文章编号]1673-7210(2010)06(c)-072-02 　　 　　Clinical observation of Gefitinib for 34 patients with advanced non-small cell lung cancer 　　DOU Hongguang, ZHAO Shuping, LI Xuehong 　　(Heilongjiang Province Land Rcelamation General Hospital, Harbin 150088, China) 　　[Abstract] Objective: To explore the efficacy and toxicity of Gefitinib for the patients with advanced non-small cell lung cancer (NSCLC). Methods: 34 patients with advanced NSCLC were unsuitable for chemoradio therapy. Gefitinib was administered orally at 250 mg, once a day until cancer progressed or serve toxicities occurred. The median time for administered of Gefitinib was 4 months. Results: Among the 34 NSCLC, no complete response (CR) and 19 partial response (PR), the objective response rate (CR+PR) was 55.9%, and the disease control rate (CR+PR+SD) was 85.3%. The median survival time was 5.6 months, and one year survival rate was 47.1% (16/34). Conclusion: Gefitinib in the treatment of patients with advanced NSCLC has better efficacy and well-tolerated toxicity. 　　[Key words] Non-small cell lung cancer (NSCLC); Gefitinib; Target therapy; Epidermal growth factor receptor 　　 　　吉非替尼是以表皮生长因子受体(EGFR)为靶点的可逆性小分子酪氨酸激酶抑制剂,能有效抑制酪氨酸激酶活性及下游信号传导,从而达到抑制EGFR生物学活性的作用,促进肿瘤细胞凋亡,增强对化疗的敏感度。我院应用吉非替尼治疗晚期NSCLC 34例,对其疗效及安全性进行了观察,现将结果报道如下: 　　1 资料与方法 　　1.1 一般资料 　　2007年5月～2008年6月我科收治放化疗失败的非小细胞肺癌晚期患者共34例,年龄33～75岁,平均60.5岁;男13例,女21例。病理类型:腺癌23例,鳞癌11例;按国际TNM分期标准,Ⅲb期8例,Ⅳ期26例;PS评分:0～1分11例,2分23例。完成2周期以上化疗者14例,2周期以下化疗者20例,入选患者中局部晚期有7例,转移性肺癌患者有27例,转移部位主要是骨、肺内、肝脏、中枢神经系统、淋巴结等。 　　1.2 治疗方法 　　吉非替尼250 mg,每日清晨口服。用至疾病进展或出现不可耐受的毒副作用,或患者要求退出。服药前及服药1个月检查血常规、肝肾功能、肿瘤标志物、心电图、彩超及胸CT,以后每2个月复查1次