IRESSA治疗化疗微效以上33例晚期非小细胞肺癌的临床价值  

Clinical Value of Sequential Gefitinib (Iressa) for Advanced Non-Small-Cell Lung Cancer with At Least a Minor Response to Chemotherapy

作　　者：韩宇[1] 徐建明[1] 宋三泰[1] 李月敏[1] 赵传华[1] 刘烈军[1] 刘建芝[1] 邱卉[1] 

机构地区：[1]军事医学科学院附属307医院肿瘤中心,北京市100071

出　　处：《中国肿瘤临床》2006年第17期970-973,共4页Chinese Journal of Clinical Oncology

基　　金：全军"十一五"科技攻关项目资助(编号:06G140)

摘　　要：目的:评价“化疗微效以上序贯给予IRESSA方案”治疗晚期非小细胞肺癌(NSCLC)的临床价值。方法:2002年5月至2005年2月,共有33例患者依次入组。既往接受化疗方案数不限,只要最后一个化疗方案疗效经确认在微效(MR)以上患者,则入组序贯给予口服IRESSA治疗,每日一次,每次250mg,持续服用直到疾病进展。结果:33例患者均可评价疗效和副作用。以入组基线检查结果为参照,总有效率(RR)为24.2%(8/33)(95%可信区间,11%～42%)。症状改善率为54.4%(18/33)(95%可信区间,25%～59%)。中位肿瘤进展时间为(TTP)6.5个月(范围:0.7～16.6),中位生存期(OS)为8.5个月(范围:2.1～18.0),1年生存率为36.4%(95%可信区间,20%～55%)。本研究中出现的毒副作用多数较轻,且可逆。30.3%的患者出现了药物相关毒副反应。主要是Ⅰ、Ⅱ级毒副反应,只有1例患者同时发生了Ⅲ级的恶心、呕吐和Ⅳ级的腹泻。结论:化疗微效以上的患者序贯应用IRESSA的方案,生活质量良好,中位肿瘤进展时间和中位生存期明显延长。其中90%以上都能继续巩固原有疗效,将近1/4患者还可以进一步提高缓解率。Objective： To evaluate the efficacy of sequential administration of gefitinib（Iressa） fol- lowing a response to two to three cycles of chemotherapy in patients with advanced non-small-cell lung cancer （NSCLC）. Methods： Thirty-three consecutive patients with advanced NSCLC pretreated with chemotherapeutic regimens, whose response to the last chemotherapy regimen was confirmed as at least a minor response （MR）, entered the trial from May 2002 to February 2005. Patients received 250 mg oral dose of gefitinib once daily for 4 weeks. Treatment was repeated every 4 weeks until disease progression. Results： Thirty-three patients were applicable for evaluation of the response and toxicity. Objective response rate was 24.2% （8 of 33） （95% confidence interval [CI], 12.3% to 30.3%）. Symptom improvement rate was 54.5% （18 of 33） （95% CI, 25% to 59%）. The median time to disease progression （TIP） was 6.5 months. The median overall survival time （OS） was 9.8 months, and the actuarial 1-year survival rate was 36.4%（95% CI, 20% to 55%）. Toxicity was relatively mild, and only one patient （3.0%） had grade 4 diarrhea, grade 3 nausea and vomiting. Conclusion： Sequential administration of gefitinib following a response to chemotherapy was better tolerated and could maintain and even enhance the effect of previous chemotherapy for advanced NSCLC.

关 键 词：IRESSA 非小细胞肺癌 序贯给药 

分 类 号：R734.2[医药卫生—肿瘤]