吉非替尼治疗老年非小细胞肺癌的临床分析

Clinical analysis of gefitinib in treatment of elderly patients with non-small cell lung cancer

为了观察吉非替尼治疗老年非小细胞肺癌(non-small celllung cancer,NSCLC)的有效性和毒副反应,回顾性研究32例经病理学或细胞学确诊的老年NSCLC,应用吉非替尼(250mg,口服1次/d)治疗,直到病情进展或出现严重不良反应。32例患者,PR8例(25.0%),SD17例(53.1%),PD7例(21.9%),有效率(CR+PR)为25%,疾病控制率(CR+PR+SD)为78.1%。女性有效率优于男性,P=0.013。病理、分期及吸烟史等各亚组之间疗效对比均差异无统计学意义,P>0.05。中位生存时间(MST)10.1个月,中位疾病进展时间(MTTP)5.7个月。腺癌和肺泡癌患者的中位生存时间及中位疾病进展时间优于鳞癌及大细胞癌患者,P值分别为0.037和0.024。吉非替尼最主要的毒副反应是皮疹(62.5%)、腹泻(30%)、皮肤干燥(46.9%)及食欲减退(25%)。3例因严重皮疹和腹泻而中断治疗。初步研究结果提示,吉非替尼单药治疗老年NSCLC疗效肯定,毒副反应相对较小,患者耐受性好。

The objective of this study was to analysis the efficacy and side effects of gefitinb in the elderly patients with non-small lung cancer （NSCLC）.A retrospective research of 32 elderly patients who were histologically or cytologically diagnosed as NSCLC and were treated with gefitinib orally 250 mg daily.Then the efficacy and side-effects of gefitinib were evaluated.All the 32 patients were evaluated.PR,SD and PD were 25.0%（8/32）,53.1%（17/32） and 21.9%（7/32）,respectively.The effective rate （CR＋PR） was 25% and the disease control rate （CR＋PR＋SD） was 78.1%.The response rate had a significant difference between the female and the male （P=0.013）.No significant difference was found in the age,pathology,stage and smoking history among the different subtypes （P〉0.05）.The median survival time （MST） and median time to tumor progression （MTTP） were 10.1 and 5.7 months,respectively.MST and MTTP were signigicantly longer in the patients of bronchioloalveolar carcinoma and adenocarcinoma than in the patients of squamous carcinoma and large cell carcinoma （P were 0.037 and 0.024）.The main toxicities of gefitinib were skin rash （62.5%）,diarrhea （30%）,asteatosis cutis （46.9%）,and anorexia （25%）.Three patients quitted the treatment because of severe rash and diarrhea.In conclusion,monotherapy with gefttinib in elderly NSCLC patients is effiective and tolerated with adverse events.