吉非替尼一线治疗肺结核合并非小细胞肺癌的临床观察

Clinical Study of Gefitinib in the First Line Treatment of Pulmonary Tuberculosis Combined with Non-small Cell Lung Cancer

目的观察吉非替尼(Gefitinib,ZDl839)作为一线化疗方案治疗肺结核合并非小细胞肺癌的治疗效果及毒副作用。方法19例活动性肺结核合并经病理学确诊的非小细胞肺癌患者,抗结核药物同时应用吉非替尼(250mg,1次/d,口服)治疗直至病情进展或出现严重不良反应。结果19例肺结核病灶均吸收好转,菌阳病例转阴。肺癌评效:获得CRl例(5.26%),PR5例(26.32%),有效率(RR)为31.58%;SD6例(31.58%);疾病控制率(DCR)为63.16%;PD7例(36.84%)。与药物相关的不良反应依次为:皮疹9例(47.37%),腹泻6例(31.58%),恶心3例(15.79%),关节痛2例(10.53%),肝功能异常2例(10.53%)。尚无因不良反应需停药者。结论吉非替尼治疗肺结核合并非小细胞肺癌疗效明确,患者耐受性好,吉非替尼并不增加抗结核药物的毒副作用。

Objective To observe the efficacy and drug-related toxicity of Gefitinib in the first-line treatment of pulmonary tuberculosis combined with non-small cell lung cancer. Methods 19 pulmonary tuberculosis patients with histologically or cytologically diagnosed Non-smallcelllungcancer were treated with anti-tuberculosis drugs and gefitinib 1 （at a dose of 250 mg perday orally）until the disease progression or toxicity has become intolerable. Results The tuberculosis all absorbs, the germ positive case turns the negative. Among these patients, complete response 1 （5. 25% ） , partial response 5 （25. 32% ） , response tate （31.58%） ; stable disease 6 （31.58 % ）, disease control rate （63.16% ） ; progpressive disease 7 （ 36. 84% ）. The median duration of response is 6. 6 months, the median time to disease progession（TTP）is 5.5 months, the median overall survival time（OS） is 11.2 months and the 1-year survival rate is 36. 6%. The drug-related adverse reactions are skin rash 9（47. 37% ）, diarrhea6（31.58% ） ,nausea3 （ 15.79% ） ,joint pain 2（ 10. 53% ） ,live injury 2（ 10. 53% ）. No one needs to stop the medicine. Conclusion Gefitinib is an effective drug in the treatment of pulmonary tuberculosis combined with non-small cell lung cancer, the toxicity can be well acceptable. Gefitinib can＇nt increase the drug-related toxicity of anti-tuberculosis drugs.