厄洛替尼二次治疗晚期非小细胞肺癌患者的临床分析  

The clinical analysis of retreatment with erlotinib in advanced non-small cell lung cancer

作　　者：吴标[1] 黄诚[1] 蒋侃[1] 朱芳[1] 郑晓彬[1] 朱凯[1] 

机构地区：[1]福建医科大学教学医院,福建省肿瘤医院内科,福建福州350014

出　　处：《中国癌症杂志》2015年第1期50-55,共6页China Oncology

基　　金：国家临床重点专科建设项目资助

摘　　要：背景与目的：厄洛替尼治疗表皮生长因子受体突变的晚期非小细胞肺癌（non-small cell lung cancer，NSCLC）患者疗效显著，但几乎所有患者最终都会出现耐药而导致病情进展。本研究旨在评估二次使用厄洛替尼治疗晚期NSCLC患者的疗效及安全性。方法：回顾性分析了福建省肿瘤医院46例既往厄洛替尼治疗有临床获益的晚期NSCLC患者，经其它药物治疗失败后二次给予厄洛替尼150 mg口服，每日1次，持续用药直至肿瘤进展或出现不可耐受的不良反应，对其临床特点、治疗效果及生存情况进行分析。结果：厄洛替尼二次治疗的客观有效率为28.3%，疾病控制率为60.9%，症状改善率为45.7%，中位无进展生存期为3.6个月，中位总生存期为7.3个月，1年生存率为8.7%。厄洛替尼停用≥6个月的患者中位无进展生存期显著长于停用＜6个月的患者（P=0.002）。ECOG评分0～2分患者中位总生存期显著长于ECOG评分＞2分的患者（P=0.038）。最常见的不良反应为皮疹和腹泻。结论：初次使用厄洛替尼有临床获益的晚期NSCLC患者，二次使用厄洛替尼仍有可能延长患者的生存时间。Background and purpose：It has a signiifcant effect for erlotinib on treatment of patients with epidermal growth factor receptor mutation in advanced non-small cell lung cancer （NSCLC）. But almost all patients will eventually progress for the resistance of drug. This study was to evaluate the efifcacy and safety of retreatment of erlotinib in patients with advanced NSCLC. Methods：It was a retrospective analysis of the 46 advanced NSCLC patients who previously treated with erlotinib and had clinical beneift. The patients were given erlotinib 150 mg orally once daily after failure to other medications until disease progression or the occurrence of intolerable toxicity. The clinical features, therapeutic effect and survival were analyzed. Results： The objective response rate of retreatment with erlotinib was 28.3%. The disease control rate was 60.9%. The rate of symptom relief was 45.7%. The median progression-free survival was 3.6 months. The median overall survival was 7.3 months. One-year survival rate was 8.7%. The median progression-free survival was signiifcant longer in the patients who stopped taking erlotinib more than 6 months than those less than 6 months （P=0.002）. The median overall survival was signiifcant longer in the patients whose ECOG ≤2 than those ECOG〉2 （P=0.038）. The most common drug-related adverse events were rash and diarrhea. Conclusion：The retreatment of erlotinib could possibly prolong the survival time of patients who previously treated with erlotinib and had clinical beneift.

关 键 词：厄洛替尼 非小细胞肺癌 治疗 

分 类 号：R734.2[医药卫生—肿瘤]