吉非替尼治疗晚期非小细胞肺癌32例疗效观察

Gefinib in Treatment of Advanced NonSmall Cell Lung Cancer :Clinical Observation of 32 Cases

目的观察吉非替尼(Gefitnib)治疗晚期非小细胞肺癌(NSCLC)的疗效、毒副作用及其对生活质量的影响。方法对不能耐受化疗或化疗失败的晚期NSCLC患者32例,口服吉非替尼250mg,1次/d,服药至出现不能耐受的毒副反应或疾病进展,定期进行疗效及毒副作用的评价。结果32例中完全缓解(CR)0例,部分缓解(PR)14例,稳定(SD)11例,进展(PD)7例,有效率(RR)43.8%(14/32),疾病控制率(DCR)78.1%(25/32)。男性患者和女性患者的有效率分别为42.9%(6/14)和44.4%(8/18)(P>0.05)。男性患者吸烟与不吸烟对其生存期有明显影响(P<0.05)。18例存活患者的中位生存时间(MST)为10.4个月,PR患者的MST为14.1个月。治疗后32例患者的KPS评分提高(20±4)分,症状改善者23例(71.9%)。无Ⅲ-Ⅳ度毒副反应。结论吉非替尼治疗晚期NSCLC疗效明显,并可用于KPS评分差的患者,其不良反应轻,有较好的治疗前景。

Objective To investigate the clinical efficacy,toxicity and impact on the life quality of patients by using gefinib as a chemotherapy regimen for patients with advanced non-small cell lung cancer（NSCLC ）. Methods Thirty-two patients with NSCLC, who could not tolerate chemotherapy or whose chemotherapy failed,were enrolled in this study. Gefitnib was given at a dose of 250mg/d. The chemotherapy would be discontinued when patients could not tolerate toxicity of gefitnib or pathogenetic condition deteriorated. All the32 cases accepted the efficacy and toxicity evaluation regularly. Results Complete response （CR）, partial response （PR）, stable disease （SD） and progressive disease（PD） were observed in 0, 14, 11 and 7 cases,respectively, with response rate（RR） of 43.8%（14/32） and disease control rate（ DCR ）78.1% （ 25/32 ）. Response rates of male and female patients were 42.9% （6/14） and 44.4% （ 8/18 ） （ P〉 0.05 ）, respectively. Median survival time（MST） of survival patients and PR patients was 10.4 months and 14.1 months,respectively. The KPS of 32 cases elevated 20± 4 scores. Symptoms of 23 cases（71.9%） were improved. Grades Ⅲ-Ⅳ of toxicity were not observated. Conclusion Gefitnib is effective and safe in the treatment of NSCLC, especially in the patients whose KPS was low.