NP方案联合吉非替尼治疗EGFR基因扩增的晚期肺腺癌的临床观察

Clinical Observation on Combination of NP Chemotherapy with Iressa in Treatment of Adenocarcinoma of Lung which gene amplification in EGFR

目的观察NP方案联合吉非替尼治疗EGFR基因扩增的晚期肺腺癌的疗效。方法选取EGFR基因扩增的晚期肺腺癌患者60例,随机分为2组。试验组30例,按NP方案静脉化疗（长春瑞滨25 mg/m2iv第1、8 d,顺铂30 mg/m2iv第1~3 d）,3周为一周期;化疗第9 d始予吉非替尼250 mg口服,每日1次,至肿瘤进展或患者不能耐受而终止治疗。对照组30例,单按NP方案静脉化疗。结果试验组和对照组在3个周期内有效率分别为83.3%、60.0%（P〈0.05）,Ⅲ~Ⅳ度骨髓抑制分别为13.3%、16.7%（P〉0.05）。结论 NP方案联合吉非替尼对EGFR基因扩增的晚期肺腺癌有较好的疗效,毒副反应能被患者接受;值得进一步探索。

Objective To discuss the curative effect of adenocarcinoma of lung which gene amplification in EGFR with Combination of NP chemotherapy with Iressa as adjunctive therapy.Methods 60 Patients of adenocarcinoma of lung which gene amplification in EGFR were randomly divided into 2 groups,the observation group（NVB＋DDP＋Iressa） and the control group（NVB＋DDP）.The NP regimem included NVB（25 mg/m2,d1,d8） and DDP（25 mg/m2,d1-3）,repeated every 3 week.The observation group received 250 mg oral doses of Iressa once a day,from d9 until disease progression or development to intolerable toxic reaction.Results 3 circle chemotherapy after the therapy was done,the disease control rate（CR＋PR） were respectively 83.3%、60.0%（P〈0.05）and the Ⅲ～Ⅳ bonemarrow suppression rate were respectively 13.3%、16.7%（P〉0.05）.Conclusion The combination of NP chemotherapy with Iressa has good therapuntica effct in adenocarcinoma of lung which gene amplification in EGFR patients with acceptable toxicity.It is worthy of further research.