IRESSA治疗晚期难治性非小细胞肺癌的临床研究  

Clinical investigation of IRESSA in the treatment of patients with advanced refractory non-small cell lung cancer

作　　者：林金容[1] 张为民[1] 谢波[1] 李荔霞[1] 张莉国[1] 郑积华[1] 王晓怀[1] 

机构地区：[1]广州军区广州总医院肿瘤科,510010

出　　处：《中国肺癌杂志》2006年第5期455-457,共3页Chinese Journal of Lung Cancer

摘　　要：背景与目的 化疗是晚期非小细胞肺癌的主要治疗手段，但是非小细胞肺癌常常对化疗耐药，先天性耐药或获得性耐药是导致非小细胞肺癌化疗失败的主要原因之一，因此寻找理想的新的抗癌药物是临床肿瘤学家的共同目标。本文旨在观察IRESSA对晚期耐药非小细胞肺癌的疗效和不良反应。方法 应用口服IRESSA 250mg／d治疗晚期耐药非小细胞肺癌100天后观察疗效。结果 33例Ⅳ期耐药非小细胞肺癌患者中32例完成口服IRESSA 100天，可评价疗效，其中完全缓解1例（3．1％），部分缓解11例（34．4％），稳定9例（28．1％），进展11例（34．4％）。有效率为37．5％，疾病控制率为65．6％。全组中位肿瘤进展时间为5．7个月，总生存期为3．3～25．9个月（中位生存时间9．6个月），9例生存时间超过1年，1年生存率为28．1％，2例生存时间超过2年，2年生存率为6．3％，最长1例存活25．9个月。IRESSA的疗效与病理类型有一定关系，肺泡细胞癌效果最佳，其次为腺癌、鳞癌。主要不良反应包括：皮疹28例（84．8％），皮肤瘙痒31例（93．9％），四肢关节疼痛9例（27．3％），腹泻25例（75．8％），食欲减退29例（87．9％），恶心14例（42．4％），呕吐4例（12．1％），头晕5例（15．2％），头痛4例（12．1％），胸闷13例（39．4％），腹痛3例（9．1％），间质性肺炎1例（3．0％），大部分不良反应可以耐受，仅1例原有慢性肺部纤维化疾病者出现严重间质性肺炎，最终因为呼吸功能衰竭导致死亡。无心电图及肝肾功能改变。结论 IRESSA对晚期耐药非小细胞肺癌具有较好的疗效，不良反应轻微，可以耐受，可以考虑做为晚期非小细胞肺癌的三线治疗方案，并且可以考虑做为一些体质较差、不能耐受手术、放疗或化疗的非小细胞肺癌患者的一线治疗。Background and objective Chemotherapy is a main method for patients with advanced nonsmall cell lung cancer （NSCLC）. NSCLC is usually a drug-resistant neoplasm. Innate or acquired drug-resistance contributes to the chief cause for bad effect in the treatment of patients with NSCLC. To search for a new anti-cancer drug becomes a goal of clinical oncologists. The aim of the present study is to evaluate the curative effect and side reactions of IRESSA in the treatment of patients with advanced refractory NSCLC. Methods The curative investigation was carried out after 100-day oral IRESSA by a dosage of 250 mg/d in patients with advanced refractory NSCLC. The patients had ever experienced at least one regimen of chemotherapy. Results Totally 33 patients enrolled in this study and all were stage Ⅳ. There were 25 males and 8 females. All enrolled patients except one patient who died of severe adverse side reaction completed treatment by IRESSA. Thirty-two cases were evaluated. Complete response was obtained in 1 patient （3.1%）. Partial response was seen in 11 patients （34.4 % ）. The overall effective rate was 37.5 % （12/32）. The disease-control rate was 65.6% （21/32）. Time to progression was 5.7 months. Overall survival time was 3.3 to 25.9 months （median survival time was 9.6 months）. One-year survival rate was 28.1% （9/32）. Two-year survival rate was 6.3% （2/32）. The longest survivor lived for 25.9 months. The curative effect was correlated with the pathological type, in sequence of alveolar cell carcinoma, adenoeareinoma and squamous cell carcinoma. Almost all the adverse reactions were acceptable. The main adverse reactions included rash, itching of skin, arthralgia, diarrhea,anorexia, nausea, vomiting, dizziness, headache, chest distress and abdominal pain. No patients showed abnormal in liver or kidney function. No electrocardiogram abnormality was found. One patient who had chronic pulmonary fibrosis before died of respiratory failure due to severe interstitial pneumonia. Conclus

关 键 词：耐药非小细胞肺癌 IRESSA 靶向治疗 不良反应 化疗 

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