吉非替尼致急性间质性肺病临床分析

Clinical analysis of acute interstitial lung disease induced by gefitinib

目的探讨吉非替尼致间质性肺病变（interstitial lung disease,ILD）的临床表现、诊断与治疗。方法回顾分析5例老年非小细胞肺癌（NSCLC）患者因服用吉非替尼致ILD的临床资料并进行相关文献复习。结果 5例NSCLC患者服用吉非替尼5-20 d后发现ILD。影像学上表现为两侧广泛的磨玻璃样改变及肺纤维化改变。及时停用吉非替尼并使用糖皮质激素后,2例好转,3例死亡。结论吉非替尼所致ILD是严重的不良反应。避免使用于高龄、吸烟的NSCLC人群,监测正在服用吉非替尼患者的肺部症状、体征,定期行胸部影像学检查是必要的。

Objective To investigate the clinical manifestations,diagnosis and treatment of gefitinib-induced interstitial lung disease（ ILD）. Methods The clinical and radiographic data of five elderly patients with non-small cell lung cancer（ NSCLC） with gefitinib-induced ILD were analyzed,and the related literatures were reviewed. Results Five cases of NSCLC presented with ILD 5-20 d after administration of gefitinib. The radiographic changes included diffuse ground—glass airspace consolidations and fibrosis in bilateral lung area. After immediately withdrawal of gefitinib and administration of corticosteroids,2 cases got better and 3 cases died. Conclusions Gefitinib-induced ILD is serious adverse reaction. It should not be used in older and smoking patients with NSCLC; And for the patients who are administered of gefitinib,it is important to monitor pulmonary symptoms and signs,and regular chest radiographic examination.