吉非替尼一线治疗晚期非小细胞肺癌临床分析

Clinical Analysis of Advanced Non-small-cell Lung Cancer Treated with Gefitinib as the First-line Treatment

目的：分析吉非替尼一线治疗56例晚期非小细胞肺癌的疗效、中位生存期、中位无进展生存期以及对相关症状的控制，探索吉非替尼作为晚期非小细胞肺癌一线治疗方案的可行性。方法：56例经病理学或细胞学证实的ⅢB期或Ⅳ期非小细胞肺癌初治患者口服吉非替尼250mg／d，直至患者死亡或肿瘤进展或发生不可耐受的毒副反应，服药前和服药后每月复查胸部CT进行肿瘤评估。结果：客观缓解率（CR＋PR）为32．1％，疾病控制率（CR＋PR＋SD）为73.2％，性别、年龄、病理、分期、吸烟史、PS评分等各亚组之间疗效对比均没有达到统计学显著性差异（P〉0．05）。中位无进展生存期3-2个月，中位生存期5．0个月，最常见毒副反应为皮肤毒性，未观察到血液学毒性。结论：吉非替尼一线治疗老年或不能耐受化疗的晚期非小细胞肺癌，显示出良好的耐受性和有效性。

Objective： Through analyzing the curative effect, median survival time, median progression-free survival and control of the related symptoms of 56 advanced NSCLC cases treated with Gefitinib as the first-line therapy, we investigated the feasibility of using Gefitinib as first-line therapy for advanced NSCLC. Methods： A total of 56 patients with advanced NSCLC of stage ⅢB or Ⅳ confirmed by pathology or cytology took Gefitinib 250mg orally once a day in initial treatment, until death or tumor progression or with-drawal by intolerable reaction. Breast CT scan was performed before treatment and after treatment once a month. Results： Objective response rate was 32.1%. Disease control rate was 73.2%. No significant difference was found in gender, age, pathology, stage, smoking history and PS score among different subtypes （P〉 0.05）. Median survival time was 5.0 months. Median progression-free survival was 3.2 months. Skin toxicity was the most common complication. Blood toxicity was not observed. Conclusion： As the first-line treatment for advanced NSCLC, Gefitinib is effective and tolerable, particularly for the elderly or those who can not afford chemotherapy.