吉非替尼治疗58例晚期非小细胞肺癌的临床观察

Clinical observation of gefitinib for 58 patients with advanced non-small cell lung cancer

目的观察吉非替尼对晚期非小细胞肺癌的临床疗效及不良反应,以及对生活质量的影响。方法选择2006年7月～2009年7月间ⅢB～Ⅳ期非小细胞肺癌患者58例,口服吉非替尼250 mg/次,每天一次,服药至病情进展或出现不能耐受的不良反应为止。结果 58例可评价非小细胞肺癌患者中,CR 1例(1.72%),PR 19例(32.76%),SD 24例(41.38%),PD 14例(24.14%),RR为34.48%,DCR为75.86%;腺癌的有效率高于鳞癌(P=0.041);女性的有效率高于男性(P=0.032);不吸烟者有效率高于吸烟者(P=0.036);接受过化疗和Ⅳ期患者有效率稍高,但无显著统计学差异(P>0.05)。中位生存时间10.6个月,1年生存率为43.6%,主要的不良反应中皮疹发生最多为39例(67.24%),腹泻14例(24.14%),肝功能轻度损害2例(3.45%)。结论吉非替尼治疗晚期非小细胞肺癌疗效好,可以显著改善非小细胞肺癌患者的临床症状及生存质量,毒副反应较小,安全易耐受。

Aim To observe the clinical efficacy,quality of life and toxic reaction of gefitinib in the treatment of patients with advanced non-small cell lung cancer（NSCLC）.Methods Fifty-eight patients with IIIB to IV NSCLC were selected from July 2006 to July 2009,The gefitinib was oral intake at 250 mg once a day until the disease progression or intolerable toxic reaction occurred.Results All 58 patients were evaluable for therapeutic effect.Among the 58 patients,1 cases got complete response（CR,1.72%）,19 cases partial response（PR,32.76%）,24 cases stable disease（SD,41.38%）and 14 cases progression disease（PD,24.14%）.The total response rate（RR）was 34.48% and the disease control rate（DCR）was 75.86%.The response rate was significantly higher in females,adenocarcinoma and nonsmokers than in males,squamous carcinoma and smokers（P0.05）.The response rate was higher in previous treatment and Ⅳ stage,but that did not show significant differences in statistics（P0.05）.The median survival time was 10.6 months.The one-year survival rate was 43.6%.The main toxicity of gefitinib was skin rash,39 cases（67.24%）,diarrhoea 14 cases（24.14%）,and mild harm of liver function 2 cases（3.45%）.Conclusion Gefitinib may obviously improve the clinical symptom and quality of life of the advanced NSCLC patient,which has the advantages of better efficacy and safe,well-tolerated toxicity.