厄洛替尼二线治疗化疗失败的晚期非小细胞肺癌的疗效观察

Effect of Erlotinib as Second-Line Therapy on Advanced Non-Small Cell Lung Cancer Following Failure of Chemotherapy

目的观察厄洛替尼治疗经一线化疗失败的晚期非小细胞肺癌(NSCLC)的临床疗效及安全性。方法经一线化疗方案治疗失败的晚期非小细胞肺癌(NSCLC)患者106例,分为实验组62例,对照组44例。两组患者均接受多西紫杉醇联合顺铂化疗方案治疗,实验组加用厄洛替尼。观察两组疗效及不良反应。结果实验组完全缓解(CR)4例、部分缓解(PR)24例、稳定(SD)28例、进展(PD)6例,对照组分别为0例、13例、14例、17例,实验组疗效优于对照组,差异有统计学意义(P<0.05);实验组疾病控制率为90.3%,缓解率为45.2%,对照组分别为61.4%、29.5%。实验组骨髓抑制反应、消化道反应发生率显著低于对照组(P<0.05)。实验组1年生存率为64.5%(40/62),显著高于对照组43.2%(19/44)(P<0.05),实验组中位生存时间、中位疾病进展时间、无进展生存期和总生存期均显著长于对照组(P<0.05)。结论厄洛替尼用于二线治疗化疗失败的晚期NSCLC有较好疗效且不良反应较少。

Objective To observe the efficacy and safety of erlotinib as the second-line therapy for advanced non small cell lung cancer（NSCLC） following failure of first-line chemotherapy.Methods One hundred and six patients with advanced NSCLC following failure of first-line chemotherapy were randomly divided into experimental group （n=62） and control group（n=44）.Two groups were both treated with docetaxel combined with cisplatin chemotherapy ,while erlotinib was added to the experimental group .The efficacy and adverse reactions were observed in two groups .Results In the experimental group,4 cases got CR,24 cases PR,28 cases SD and 6 cases PD,while in the control group ,CR were 0 cases,PR 13 cases,SD 14 cases and PD 17 cases.The efficacy in the experimental group was better than that in the control group（P〈0.05）.In the experimental group,the disease control rate （DCR） was 90.3%,the response rate （ RR） was 45.2%,while in the control group ,the DCR was 61.4%,the RR was 29.5%.The incidences of bone marrow suppression and gastrointestinal reaction in the experimental group were significantly lower than those in the control group（P〈0.05）.The 1-year survival rate in the experimental group was 64.5%（40/62）,significantly higher than that （43.2%,19/44） in the control group（P〈0.05）.The median survival time,median time to progression,progression free survival and overall survival in the experimental group were significantly longer than those in the control group （ P〈0 .05 ） .Conclusion Erlotinib as the second-line therapy for NSCLC following failure of chemotherapy has better curative effect and less adverse reactions .