吉非替尼治疗晚期肺腺癌的临床观察

Clinical obeservation of gefitinib in treatment of advanced adenocarcinoma of lung

目的观察吉非替尼对一线化疗失败的晚期肺腺癌预后的影响,评价吉非替尼的临床安全性。方法 24例一线化疗失败肺腺癌患者,口服吉非替尼,250 mg/d,至少服药后4周疗效评价为疾病得到控制,继续服药直至疾病进展或出现不可耐受的不良反应。结果完全缓解(CR)0例,部分缓解(PR)9例(37.5%),稳定(SD)15例(62.5%),疾病缓解率(CR+PR)37.5%。截至2012年7月1日,24例患者中死亡15例,疾病进展2例,中位疾病进展时间为16.5个月,中位生存时间为19.1个月,1年生存率为76.4%;病情稳定继续服药者7例,疾病控制稳定最长者48个月,最短8.6个月。患者服药期间主要不良反应为Ⅰ～Ⅱ度胃肠道反应,皮肤反应以皮疹为主,可耐受。结论吉非替尼可明显改善一线化疗失败的晚期肺腺癌预后,安全性较好。

Objective To investigate the treatment effect and adverse reactions of gefitinib in the failed first-line treatment of advanced adenocarcinoma of lung.Methods 24 patients,with advanced adenocarcinoma of lung and first-line chemotherapy failed,they orally took gefitinib 250 mg once a day,taken the efficacy evaluation for disease control after four weeks at least,until the emergence of PD or intolerable adverse reactions.Results Zero cases achieved complete remission（CR）,9 cases achieved partial remission（PR）,15 cases achieved stable disease condition（SD）,the total effective rate（CR＋PR）was 37.5%.As of July 1,2012,15 of 24 cases died,2 cases achieved PD,the median disease progression time（TTP） was 16.5 months,the median survival time（MST） was 19.1 months,and the 1-year survival rate was 76.4%;7 cases with stable disease condition was still to take drugs,the disease control was stable for up to 48 months,the shortest 8.6 months.The most common adverse events wereⅠ~Ⅱdegrees of gastrointestinal reactions and skin rash.Conclusions Gefitinib has better treatment effect and for tolerability for advanced adenocarcinoma of lung.