厄罗替尼一线治疗中晚期非小细胞肺癌老年患者的临床观察  

Efficacy and safety of erlotinib as first-line treatment in the elderly patients with advanced non-small cell lung cancer

作　　者：苏进[1,2] 许新华[1,2] 李道俊[1,2] 黄乔[3] 鲁明骞[3] 薛峰[1,2] 易芳[3] 

机构地区：[1]三峡大学第一临床医学院 [2]宜昌市中心人民医院肿瘤科,宜昌443003 [3]三峡大学肿瘤研究所,宜昌443003

出　　处：《肿瘤》2012年第2期130-133,共4页Tumor

基　　金：湖北省卫生厅科研项目(编号:JX4B52);2011年宜昌市科技研究与开发项目(编号:A11301-04)

摘　　要：目的:评价厄罗替尼一线治疗中晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)老年患者的疗效和安全性。方法:2007年5月—2008年12月首次确诊的35例70～81岁中晚期NSCLC老年患者,其中鳞状细胞癌18例、腺癌13例、细支气管肺泡癌4例;吸烟者19例,不吸烟者16例。所有患者均接受厄罗替尼150mg/d口服治疗,直至疾病进展或出现无法耐受的不良反应。对所有患者均进行随访,观察近期疗效和不良反应,并计算生存情况。结果:35例患者中,1例获得完全缓解,16例获得部分缓解,10例疾病稳定,8例疾病进展;总有效率为48.6%(17/35),疾病控制率为77.1%(27/35)。中位至疾病进展时间为6.4个月,中位总生存期为12.7个月,1年生存率为48.6%(17/35)。性别、病理类型和吸烟史与疾病控制率相关(P<0.05)。不良反应主要为皮疹和腹泻,只有1例患者因较为严重的皮疹和腹泻而减少厄罗替尼剂量。结论:厄罗替尼一线治疗中晚期NSCLC老年患者可取得较好的疾病控制率和临床获益,不良反应可以耐受。Objective：To evaluate the efficacy and safety of erlotinib as first-line treatment for the elderly patients with advanced non-small cell lung cancer（NSCLC）.Methods：Thirty-five elderly patients（70-80 years of age） with initial diagnosis of advanced NSCLC confirmed by pathological examinations between May 2007 and December 2008 were recruited into this prospective study,including squamous-cell carcinoma in 18 patients,adenocarcinoma in 13 patients,and bronchioloalveolar carcinoma in 4 patients.Of these 35 patients,19 had a history of smoking,and 16 were non-smokers.All patients received erlotinib（150 mg/d） as first-line treatment which was continued until disease progression or intolerable toxicity occurred.The short-term response and the adverse reactions were observed.The follow-up was performed,and the survival was analyzed.Results：Of the 35 patients,1 patient had complete response,16 patients had partial response,10 patients had stable disease,and 8 patients had progressive disease;the overall response rate was 48.6%（17/35）,and the disease control rate was 77.1%（27/35）.The median time to progression was 6.4 months,and the median overall survival was 12.7 months;the one-year survival rate was 48.6%（17/35）.The factors of gender,pathology and smoking history were associated with the disease control rate（P0.05）.The major erlotinib-related adverse reactions were rash and diarrhea,and the dose of erlotinib was reduced in only one patient due to severe rash and diarrhea.Conclusion：The elderly patients with advanced NSCLC have clinical benefits of erlotinib as first-line treatment,and the disease control rate and the clinical benefit rate are both acceptable,as well as the adverse reactions are tolerable.

关 键 词：癌 非小细胞肺 厄罗替尼 老年人 治疗结果 生存分析 不良反应 

分 类 号：R734.2[医药卫生—肿瘤]