吉非替尼治疗男性晚期非小细胞肺癌59例报告

Gefitinib in the treatment of male patients with advanced non-small-cell lung cancer

目的探讨吉非替尼单药治疗男性晚期非小细胞肺癌(NSCLC)的疗效及安全性。方法男性NSCLCⅣ期患者59例,其中腺癌、细支气管肺泡癌占86.4%,既往化疗2个方案以上者占66.1%。口服吉非替尼至病情进展或出现不可耐受不良反应。患者分别于治疗1个月、治疗3个月、治疗3个月以后每隔2个月复查。结果59例患者均可评价疗效,无完全缓解患者,部分缓解14例,稳定10例,进展35例,有效率为23.7%,稳定率为16.9%,疾病控制率为40.7%。中位肿瘤进展时间为1.8个月。中位生存时间为8.5个月,生存时间与最佳疗效及一般状况有关。1、2和3年生存率分别为42.4%、17.1%和13.3%。常见不良反应为皮肤改变和腹泻,多为1、2度。结论吉非替尼单药治疗男性晚期NSCLC疗效明确,疾病控制后患者生存时间延长,不良反应较易耐受,是二线、三线用药的良好选择。

Objective To investigate the antitumor efficacy, time to tumor progression （TIP） and toxicity of gefitinib （Iressa, ZD1839 ） - a selective epidermal growth factor receptor tyrosine kinase inhibitor in the treatment of male patients with advanced non-small-cell lung cancer（NSCLC）. Methods Fifty-nine male patients with stage IV NSCLC orally took Iressa 250 mg once daily until disease progression or intolerable toxicity ocurred. They were required to conduct tumor-evaluation before the treatment, one month after Iressa administration and then every other month. Results Of these 59 patients, no complete regression was observed, 23.7% had partial response（ PR）, and 16.9% stable disease（SD） with a disease control（ PR ＋ SD） rate of 40.7% , while 59.3% had progress of disease （PD）. The median time to tumor progression（TIP） was 1.8 months, and the median survival was 8.5 months. Fifty-nine patients were followed up over one year, 55 over two year and 15 over three year, and the 1-, 2- and 3-year survival rates were 42.4% ,17.1% and 13.3%. The most common adverse effects were grade 1 or 2 skin reaction and diarrhea. Conclusion Iressa is effective in antitumor for the male patients with advanced non-small-cell lung cancer, and can improve the survival for those responsing to gefitinib. The adverse effects are usually tolerable.