吉非替尼治疗有浆膜腔积液与无浆膜腔积液NSCLC比较研究  

Comparison study on gefitinib in the treatment of non-small cell lung cancer with and without malignant effusion

作　　者：高玉伟[1] 王年飞[1] 黄忠连[1] 陈振东[1] 

机构地区：[1]安徽医科大学第二附属医院肿瘤中心,安徽合肥230601

出　　处：《中华肿瘤防治杂志》2014年第10期775-779,共5页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:探讨吉非替尼治疗伴恶性浆膜腔积液的非小细胞肺癌(non-small cell lung cancer,NSCLC)疗效及生存状况。方法:回顾分析安徽医科大学第二附属医院2006-09-01-2013-01-30,吉非替尼(250mg/d)治疗有效>6个月的77例NSCLC患者的临床资料。χ2检验评价有恶性浆膜腔积液和无恶性浆膜腔积液患者近期客观疗效、主观症状改善情况和生活质量,Kaplan-Meier法进行生存分析。结果:77例患者中,伴有恶性浆膜腔积液35例,无恶性浆膜腔积液42例。恶性浆膜腔积液组及无恶性浆膜腔积液组的客观有效率分别为88.9%(31/35)和86.9%(35/42),差异无统计学意义,P=0.513。生活质量改善率分别为97.1%(34/35)和88.1%(37/42),P=0.295。中位总生存期分别为27和35个月,χ2=1.655,P=0.198。中位无进展生存期分别为20和22个月,χ2=0.224,P=0.636。主观症状改善出现中位时间分别为7.5和15.5d,差异有统计学意义,χ2=17.612,P<0.001;其中恶性浆膜腔积液组主观症状改善出现与客观疗效显现的中位时间分别为7.5和30d,差异有统计学意义,P<0.001。结论:吉非替尼治疗伴恶性浆膜腔积液的NSCLC具有较好的疗效,无论在生活质量还是生存时间上均不比无恶性浆膜腔积液的患者差,尤其是主观症状改善早于后者,且其主观症状改善常先于客观疗效。OBJECTIVE：To explore the the efficacy and surviral state of patients with malignant effusion from nonsmall cell lung cancer（NSCLC）treated by gefitinib.METHODS：From September 1st,2006to January 30th,2013,the clinical data of patients with NSCLC who had response to gefitinib（250mg/d）for more than 6months were anlysised restrospectivly in our hospital.The data of objective effect,clinical symptoms,quality of life and survival time for patients were analyzed using theχ 2 test,and survival analysis were made by Kaplan Meier method.RESULTS：There were 77patients enrolled in the study,including 35patients with malignant effusion and 42without.The objective response rate（CR ＋PR）was 88.9%（31/35）in group with malignant effusion compared to 86.9%（35/42）in group without,which showed no statistical significance（P=0.513）.The improvement rate of quality of life was 97.1%（34/35）in group with malignant effusion compared to 88.1%（37/42）in group without（P=0.295）.The median overall survival（OS）was 37months and 35months respectively,which had no statistical significante（χ ^2= 1.655,P=0.198）.The median progression free survival（PFS）was 20months and 22months respectively,the difference was not statistically significante（χ ^2=0.224, P=0.636）.The median time of the clinical symptoms improved was 7.5days and 15.5days respectively,the difference was statistically significante（χ ^2=17.612,P〈0.001）.In the group with malignant effusion,the median time of objective response and the clinical symptoms improved was 7.5days and 30days respectively,the difference was statistically significante（P〈0.001）.CONCLUSION：Patients with malignant effusion from NSCLC could gain higher efficacy from the administration of gefitinb,of whom,neither efficacy nor surviral state is worse than those without malignant effution,especially the time of clinical symptoms improved was much earlier than that of the later,and their clinical symptoms improvement preceded the objective response.

关 键 词：非小细胞肺癌 吉非替尼 恶性胸腔积液 恶性心包积液 生活质量 

分 类 号：R734.2[医药卫生—肿瘤]