吉非替尼治疗非小细胞肺癌有效6个月后疾病进展继续原药治疗的临床观察  

Clinical observation of continuing administration of gefitinib for progressed non-small cell lung cancer patients 6 months after initially responding

作　　者：陈婵娟[1] 陈振东[1] 孙彤[1] 杨扬[1] 程怀东[1] 宗恒 

机构地区：[1]安徽医科大学第二附属医院肿瘤中心,合肥230601 [2]安徽省第二人民医院肿瘤科,230061

出　　处：《临床肿瘤学杂志》2013年第3期229-232,共4页Chinese Clinical Oncology

基　　金：国家自然科学基金资助项目(81141103)

摘　　要：目的观察吉非替尼治疗非小细胞肺癌(NSCLC)有效6个月后疾病进展的患者,应用原药继续治疗的临床表现、生活质量(QOL)及后续生存时间。方法吉非替尼250mg/d治疗NSCLC有效超过6个月后疾病进展的患者继续原药治疗为试验组(n=39),6个月后未进展的患者继续维持治疗为对照组(n=49),采用卡氏行为状态评分(KPS)及癌症患者生活功能指数量表(FLIC)评价两组患者的QOL,并比较试验组不同进展部位对后续生存时间的影响及初始进展至加速进展与加速进展至死亡两个时间段的QOL。结果试验组患者初始进展KPS及FLIC量表评分维持进展前水平的时间为1.0～24.0个月,中位时间6.0个月,直到死亡前1～3个月与对照组患者的差异无统计学意义(Z=-0.976,P=0.329;Z=-0.029,P=0.977)。试验组初始进展至加速进展与加速进展至死亡两个时间段的KPS评分分别为(85.00±7.31)分和(48.00±9.25)分,差异有统计学意义(P<0.001);FLIC量表评分分别为(121.24±18.16)分和(75.57±21.45)分,差异有统计学意义(P<0.001)。在试验组中,靶病灶进展和非靶病灶进展的后续中位生存时间分别为7.0个月和10.0个月,差异有统计学意义(P=0.018)。结论吉非替尼治疗NSCLC有效6个月后进展,原药继续治疗在一段时间内仍可能获益,特别是对仅出现非靶病灶进展的患者。Objective To observe the clinical manifestation, quality of life（QOL） and follow-up survival of patients with non- small cell lung cancer（NSCLC） who had initial response to gefitinib for more than 6 months and maintained administration of the regi- men even after failure of gefitinib. Methods Gefitinib was taken orally at a dosage of 250 mg daily. The NSCLC patients who had been administrated the regimen successfully more than 6 months were divided into the trail group （ whose disease progressed, n = 39 ） and the control group （ whose disease didn＇t progress, n = 49 ）. The QOL for patients with Karnofsky Performance Status Scale （KPS） and Functional Living Index-Cancer（FLIC） were evaluated. The follow-up survival of the target lesions progression and the non-target lesions progression were calculated. Results The favorable scores of KPS and FLIC were still kept on 1.0-24. 0 months to the patients in the trail group, and the median time was 6. 0 months. KPS and FLIC scores were compared by the two groups, and the differences had no significance （ Z = - 0. 976, P = 0. 329 ; Z = - 0. 029, P = 0. 977 ）. In the trail group, during the period of initial progress to dis- ease flare and in the period of disease flare to death, the scores of KPS were 85.00±7.31 and 48.00 ±9. 25 （P 〈 0. 001 ） ;and the scores of FLIC were 121.24±18. 16 and 75.57±21.45 （P 〈 0. 001 ）. The median follow-up survival of patients with the target lesion progress and non-target lesions progress were 7. 0 months and 10. 0 months in the trail group, and the difference was significant（ P = 0. 018）. Conclusion The patients with NSCLC could gain clinical benefits from continuing the administration of gefitinib, who ac-quired resistance to the regimen in spite of initial responses to it, especially for the patients with non-target lesion progress.

关 键 词：非小细胞肺癌 吉非替尼 生活质量 生存时间 疾病进展 

分 类 号：R734.2[医药卫生—肿瘤]