厄洛替尼治疗晚期非小细胞肺癌36例临床观察

Clinical observation of erlotinib in the treatment for 36 patients with advanced non-small cell lung cancer

目的探讨厄洛替尼单药一线或二线治疗晚期非小细胞肺癌的疗效及不良反应。方法收集36例我科就诊的ⅢB期或者Ⅳ期非小细胞肺癌病例:所有患者均为病理学确诊,患者因体力状态较低一线选择厄洛替尼或至少接受1～2个周期化疗,治疗失败或因毒副反应不能耐受后二线选择口服厄洛替尼,具体用法:150 mg/qd,直至病情进展或者不能耐受副反应。结果在36例患者中,CR0例,PR 9例(25.0%),SD17例(45.2%),PD10例(27.8%),ORR为25.0%,DCR为72.2%。中位TTP为5.3个月,统计学结果显示:病理学类型与患者的DCR有关(P=0.029),腺癌的DCR较高。最常见的不良反应为皮疹及腹泻,经对症处理后可好转。结论厄洛替尼治疗晚期非小细胞肺癌疗效较好,不良反应较轻。

Objective To investigate the curative effect and the side effect of targeted drug of erlotinib in the treatment of patients with advanced non-small cell lung cancer （NSCLC） as the first or second line. Methods 36 patients who with NSCLC at Ⅲ A or Ⅳ stage were selected in this study, were all confirmed by pathology or cytology. Firstly those patients who were with low physical state were given erlotinib as the first line treatment or at least one to two cycles of chemotherapy when until death or disease progression or intolerable toxici- ty occurred, then they were orally applied with erlotinib as the second line treatment. The curative effect and the adverse reactions were compared between the two groups. Results There was no CR case, 9 PR cases （25.0%） , 17 SD cases （45.2%） , and 10 PD cases （27.8%）. The overall response rate （ORR） was 25.0% , and the disease control rate （IDCR） was 72.2%. The median progression-free survival was 5.3 months. The statistics showed the patients with adenocarcinoma had a significant higher DCR than those with squamous carcinoma （P = 0. 029）. The common adverse reactions of erlotinib were rash and diarrhea which could be controlled after treatment. Conclusion Erlotinib has favorable curative effect and slight adverse reactions in the treatment of patients with non-small cell lung cancer.