吉非替尼(Iressa)治疗手术、放疗、化疗治疗后失败的非小细胞肺癌的初步报告  

Iressa for refractory non-small cell lung cancer: A preliminary report

作　　者：蒋国 洪小南[2] 樊旼[1] 王佳蕾[2] 傅小龙[1] 钱浩[1] 丁琳[1] 

机构地区：[1]复旦大学附属肿瘤医院放疗科,上海200032 [2]复旦大学附属肿瘤医院化疗科,上海200032

出　　处：《中国肺癌杂志》2004年第4期305-308,共4页Chinese Journal of Lung Cancer

摘　　要：目的　总结用吉非替尼 (Iressa)治疗难治性非小细胞肺癌 (NSCLC)患者的初步经验。方法　 5 5例难治性NSCLC进入研究 ,均为手术、放疗、化疗等现代的肿瘤治疗手段治疗后失败的病例。其中 5例的肿瘤局限于胸腔内 ,5 0例已有了远处转移。Iressa剂量为 2 5 0mg/次 ,口服 ,每天 1次。全组服药的中位时间为4个月。结果　主要的毒副作用是皮疹 ,发生于 2 6例患者 ,占全组的 47%。其他的副作用有腹泻 4例 ( 7%) ,恶心 4例 ( 7%) ,口腔粘膜溃疡、脱发、胃出血各 1例 ( 2 %)。上述毒副作用均不严重 ,患者均能耐受。全组的有效率为 2 0 %。Iressa对不同的远处转移部位有不同的效应 ,对两肺内的粟粒样播散的有效率更高。患者的主观感觉和临床症状好转 >2周的患者占 2 5 %。中位生存期为 5个月 ( 1～ 17个月 ) ,中位肿瘤进展时间是 3 .6个月。 6月生存率为 67%。与疗效有关的因素是 :有皮肤反应的患者有效率明显高 ,中位生存期长 (P <0 .0 5 ) ,与性别、肿瘤组织类型、远处转移部位无关。结论　对治疗难治性NSCLC患者 ,Iressa治疗的毒性和副作用轻微 ,能为患者耐受 。Objective To summarize the preliminary experience on Iressa for refractory non small cell lung cancer (NSCLC). Methods Fifty five patients with NSCLC, who failed after surgery, radiotherapy, chemotherapy or combination of the above modalities, were registered in this clinical trail. Prior to Iressa, 50 patients were in stage Ⅳ, and 5 in stage Ⅲ. Iressa was administered orally at 250 mg, once a day until cancer progressed or severe toxicity occured, which made patients intolerable. The median time for administration of Iressa was 4 months. Results The toxicity of Iressa was tolerable with 47% of skin toxicity (rash) and 2% 7% of diarrhea, nausea, orally mucosal ulceration and alopecia. Overall response rate was 20%. Different sites of distant metastases responded to Iressa in different ways with higher response rate for pulmonary disseminations. One quarter of patients felt improvement of their symptoms over 2 weeks. Median survival time for entire group was 5 months (1 17 months). Median time to progression (TTP) was 3.6 months. Survival at 6 months was 67%. Prognostic predictor, which could imply the outcome, was skin toxicity with higher response rate and longer survival time ( P <0.05), and no relationship with sex, histological types of NSCLC and distant metastasis had been found. Conclusion Iressa could be tolerated by refractory NSCLC patients with acceptable side effects, and have palliative effects.

关 键 词：难治性非小细胞肺癌 IRESSA 

分 类 号：R734.2[医药卫生—肿瘤] R730.5[医药卫生—临床医学]