1例吉非替尼致间质性肺炎的病例分析  

A case analysis of interstitial pneumonia induced by gefi tinib

作　　者：许多[1] 刘梅[1] 王卓[2] 陆蕾[3] 

机构地区：[1]解放军第四五四医院药剂科,江苏南京210002 [2]第二军医大学长海医院药学部,上海200433 [3]解放军第三二三医院药剂科,陕西西安710054

出　　处：《中国药物应用与监测》2016年第2期130-132,共3页Chinese Journal of Drug Application and Monitoring

摘　　要：1例53岁女性患者因确诊右下肺腺癌入院,经多方案化疗疗效欠佳,后改为培美曲塞与吉非替尼序贯治疗。应用吉非替尼16 d后,患者出现间断性发热,咳少量白色黏液痰,最高体温39℃,查胸部CT提示:双肺多见弥漫性浸润性阴影伴少量胸腔积液,给予抗感染、化痰等对症治疗后症状未缓解,评估疾病状态,排除肺癌进展,考虑为吉非替尼所引发的间质性肺炎。给予醋酸泼尼松片对症治疗37 d,患者复查胸部CT示双肺间质炎症较前吸收。之后患者未再服用吉非替尼,10 d后再次入院进行评估,改用埃克替尼控制疾病进展,随访2个月未再出现发热、咳嗽咳痰等症状。One 53-year-old female patient was diagnosed with the right lower lung adenocarcinoma. After several roundsof unsuccessful chemotherapies, the patient received sequential therapy of pemetrexed and gefitinib. Application of gefitinib 16 dayslater, the patient presented with intermittent fever, cough a few white mucus, and highest temperature of 39 ℃. Diffuse infiltrationshadow can be seen along with a small amount of pleural effusion by CT examination. The patient was treated with anti-infective andother symptomatic treatment, but the symptoms were not alleviated. After assessment of disease state, the lung cancer progressionwas excluded, then the symptoms were considered as gefitinib-induced interstitial pneumonia. The patient was received prednisoneacetate tablets for the treatment of interstitial pneumonia for 37 days, the chest CT examination showed bilateral pulmonaryinterstitial inflammation had been absorbed. The patient has no longer taken gefitinib. After 10 days, the patient readmitted to hospitalfor disease assessment. Finally, the patient took icotinib to control the disease progression, and no fever, coughing sputum and othersymptoms were observed in the following next 2 months.

关 键 词：吉非替尼 非小细胞肺癌 间质性肺炎 埃克替尼 药品不良反应 

分 类 号：R734.2[医药卫生—肿瘤] R563.1[医药卫生—临床医学]