依维莫司治疗多线化疗后晚期非小细胞肺癌的临床疗效和安全性分析

Efficacy and safety of everolimus for patients with advanced non-small cell lung cancer after failure of multi-line therapy

目的探索依维莫司联合靶向治疗或化疗对多线治疗后的晚期非小细胞肺癌的临床疗效和安全性。方法回顾性分析我院2013年5月-2014年5月采用依维莫司联合靶向治疗或化疗的方案以小剂量逐渐加药法治疗21例多线治疗后进展的晚期非小细胞肺癌患者的临床疗效和不良反应情况。结果 21例中,男18例,女3例,中位年龄52岁,肿瘤分期均为Ⅳ期。4例因2级/3级不良反应放弃服药,稳定9例（52.9%）,疾病进展8例（47.1%）,未出现完全缓解和部分缓解患者,疾病控制率52.9%。中位无进展生存期3个月（95%CI：2.337~3.663）,中位生存期7.8个月（95%CI：6.187~9.413）。患者耐受基本良好,出现4例3级/4级不良反应,表现为口腔炎和间质性肺炎,其余不良反应均为1级/2级。结论依维莫司联合化疗或靶向治疗,以小剂量逐渐加量法治疗多线治疗后进展晚期非小细胞肺癌临床疗效较好,耐受性良好。

Objective To investigate the clinical efficacy and adverse events of everolimus treated in patients with advanced non- small cell lung cancer （NSCLC） who underwent multi-line therapy. Methods Clinical data about 21 patients who underwent everolimus combined with targeted therapy or chemotherapy in our hospital from May 2013 to May 2014 were retrospectively analyzed to assess efficacy and toxicity. Results Of the 21 patients, 18 males and 3 females with median age of 52 years were in IV tumor staging. Four cases gave up for grade 2/3 adverse events, stable disease was found in 9 cases （52.9%） and progressive disease in 8 cases （47.1%）, resulting a disease control rate of 52.9%. The median progression-free survival was 3 months （95% CI： 2.337-3.663） and the median overall survival was 7.8 months （95% CI： 6.187-9.413）. The main grade 3/4 toxicity was stomatitis and interstitial pneumonia. Conclusion Everolimus combined with targeted therapy or chemotherapy in a way of gradually increasing the dose of everolimus shows good objective responses and well tolerance in advanced NSCLC patients undergoing multi-line treatment.