厄洛替尼治疗晚期非小细胞肺癌的临床观察

CLINICAL OBSERVATION OF ERLOTINIB IN THE TREATMENT OF ADVANCED NON-SMALL CELL LUNG CANCER

目的:本研究旨在探讨厄洛替尼治疗晚期非小细胞肺癌的疗效、影响因素和毒副作用。方法:对接受过1个周期以上含铂化疗方案失败的晚期非小细胞肺癌病人,每天口服150mg厄洛替尼直至疾病进展或出现不能耐受的毒副作用,观察疗效、生存时间和不良事件。结果:2008-12～2010-12,共有60例入组,全组60例病人均可以评价疗效,其中CR3例(5%),PR25例(41.7%),SD20例(33.3%),PD12例(20%),RR为46.7%,DCR48例(80%)。中位无进展生存期10.2mo,中位生存期16.3mo,1年生存率66.7%。腺癌病人无进展生存期8.5mo,非腺癌病人为3.2mo,差异有统计学意义(χ2=15.944,P=0.001);未出现皮疹者中位无进展生存期1.2mo,出现皮疹者8.2mo,出现皮疹者较未出现皮疹者总生存期明显延长(χ2=19.377,P=0.001)。最常见的毒副反应为皮疹(90%)和腹泻(11.7%),多为轻、中度。结论:厄洛替尼治疗晚期非小细胞肺癌疗效明确,不良反应较轻,耐受性较好。

objective： To evaluate the efficacy,influencing factors and toxicity in patients with NSCLC by erlotinib.Methods： Patients with NSCLC who had been previously treated with at least one course of platinum based chemotherapy received 150 mg oral doses of erlotinib once daily until disease progression.Response rate,progression free survival,overall survival and toxicity profile were analyzed.Results： Sixty patients were enrolled into the study from 2008-12～2010-12.Among the 60 NSCLC patients,3 patients got complete response（5%）,25 partial response（41.7%）,20 stable disease（33.3%） and 12 progressive disease（20%）.The overall response rate and the disease controlled rate of erlotinib was 46.7% and 80%.The median progression-free survival time was 10.2 months;the median survival time was 16.3 months;the one-year survival rate was 66.7%.The median PFS of patients with adenocarcinoma and with non-adenocarcinoma was 8.5 months vs 3.2 months（χ2=15.944,P=0.001）.The median PFS of patients with rash and no rash was 8.2 months vs 1.2 months（χ2=19.377,P=0.001）.the most common side effects were rash and diarrhea with 90% and 11.7%,respectively,but usually were mild.Conclusion：Erlotinib is effective and safe in the treatment of advanced NSCLC patients.