吉非替尼与厄洛替尼治疗非小细胞肺癌脑转移的临床观察  

Clinical observation of gefitinib and erlotinib for brain metastases of non-small cell lung cancer

作　　者：白皓[1] 熊丽纹[1] 韩宝惠[1] 姜丽岩[1] 

机构地区：[1]上海交通大学附属胸科医院呼吸内科,上海200030

出　　处：《临床肿瘤学杂志》2015年第11期1028-1031,共4页Chinese Clinical Oncology

摘　　要：目的探讨吉非替尼与厄洛替尼治疗非小细胞肺癌脑转移的疗效。方法回顾性分析67例EGFR突变阳性的肺腺癌脑转移患者的病历资料,患者均口服吉非替尼250 mg/天(吉非替尼组,n=38)或厄洛替尼150 mg/天(厄洛替尼组,n=29),直至发生颅内病变进展、死亡或不可耐受的不良反应。疗效分析采用RECIST 1.1版标准,生存分析采用KaplanMeier法并行Log-rank检验。结果全组颅内病变的有效率(RR)和疾病控制率(DCR)分别为44.8%和92.5%,吉非替尼组和厄洛替尼组分别为42.1%、92.1%和48.3%、93.1%(P=0.881)。颅外病变的RR和DCR分别为53.7%和95.5%,吉非替尼组和厄洛替尼组分别为52.6%、94.7%和55.2%、96.6%(P=0.932)。全组患者的中位无进展生存期(PFS)和总生存期(OS)分别为10.8个月和15.3个月,吉非替尼组和厄洛替尼组分别为10.6个月、14.8个月和11.7个月、15.7个月(P=0.720,P=0.569)。结论吉非替尼和厄洛替尼对EGFR突变阳性的非小细胞肺癌脑转移具有较好的疗效,可以作为脑转移患者的治疗选择,两种药物在脑转移瘤的疗效及患者的预后等方面无差异。Objective To evaluate clinical efficacy and prognosis of gefitinib and erlotinib against brain metastases of nonsmall cell lung cancer（ NSCLC） and to compare the difference between two drugs. Methods A total of 67 brain metastases patients of pulmonary adenocarcinoma harboring activating EGFR mutation were reviewed retrospectively. All of them were treated with oral either gefitinib（ 250 mg/day,n = 38） or erlotinib（ 150 mg/day,n = 29）. These patients discontinued administration of gefitinib or erlotinib when intracranial disease progression,death or intolerable side effects appeared. RECIST 1. 1 was applied in response analysis. Survival analysis was compared with Kaplan-Meier method and Log-rank test respectively. Results In terms of intracranial diseases,response rate（ RR） and disease control rate（ DCR） were 44. 8% and 92. 5%,respectively. Furthermore,RR and DCR were 42. 1%,92. 1% and 48. 3%,93. 1% in gefitinib and erlotinib group,respectively（ P = 0. 881）. As for extracranial diseases,RR and DCR were 53. 7% and 95. 5%,respectively. In addition,RR and DCR were 52. 6%,94. 7% and 55. 2%,96. 6% in gefitinib and erlotinib group,respectively（ P = 0. 932）. The median progression free survival（ PFS） and overall survival time（ OS） was 10. 8 months and15. 3 months,respectively. Furthermore,median PFS and OS was 10. 6 months,14. 8 months and 11. 7 months,15. 7 months in gefitinib and erlotinib group,respectively（ P = 0. 720,P = 0. 569）. Conclusion Gefitinib and erlotinib showed promising antitumor activity against brain metastases in NSCLC patients harboring activating EGFR mutation and appear to be the treatment of choice in this clinical setting. Gefitinib and erlotinib seem to show no difference in efficacy and prognosis of these patients.

关 键 词：非小细胞肺癌 脑转移 吉非替尼 厄洛替尼 

分 类 号：R734.2[医药卫生—肿瘤]