表皮生长因子受体酪氨酸激酶抑制剂一线治疗老年晚期非小细胞肺癌的临床研究  

Clinical study of EGFR-TKIs as first-line treatment in the elderly patients with advanced non-small cell lung cancer

作　　者：丁忠海[1] 计婧[1] 许林[2] 史美祺[3] 伏杭江[1] 

机构地区：[1]中国人民解放军南京军区南京总医院干部保健科,江苏省南京市210002 [2]江苏省肿瘤医院胸外科,江苏省南京市210009 [3]江苏省肿瘤医院肿瘤内科,江苏省南京市210009

出　　处：《实用老年医学》2017年第4期319-323,共5页Practical Geriatrics

摘　　要：目的观察老年晚期非小细胞肺癌(NSCLC)病人一线应用表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs)靶向治疗药物的疗效及安全性。方法选取老年晚期NSCLC病人126例,应用吉非替尼(250mg,1次/d口服)59例,应用厄洛替尼(150 mg,1次/d口服)16例,应用埃克替尼(125 mg,3次/d口服)51例。观察3组病人接受不同EGFR-TKIs治疗的疗效、不良反应及无进展生存期(PFS)。结果 2例不能耐受而中止用药,1例自行放弃治疗,共123例完成治疗。无完全缓解(CR)病例,部分缓解(PR)61例,稳定(SD)33例,进展(PD)29例,有效率(ORR)为49.6%,疾病控制率(DCR)为76.4%。全组病人中位无进展生存期(m PFS)为10.2月。吉非替尼、厄洛替尼、埃克替尼各组间疗效差异无统计学意义(P>0.05)。结论老年晚期NSCLC病人应用吉非替尼、厄洛替尼、埃克替尼安全有效,不良反应轻微,均可耐受。Objective To investigate the efficacy and safety of epidermal growth factor receptor tyrosine kinase inhibitors （EGFR-TKIs） as the first-line therapy in the elderly patients with advanced non- small cell lung cancer （NSCLC）. Methods One hundred and twenty-six elderly patients with advanced NSCLC were enrolled, among whom 59 cases were treated with gefitinib （ 250 mg, qd）, 16 with erlotinib （ 150 mg,qd） ,and 51 cases with icotinib （ 125 mg,tid）.The efficacy, adverse reactions, and progression- free survival after EGFR-TKI therapy were observed. Results Two cases discontinued the medication because of intolerance, and one case give up treatment voluntarily, 123 patients finished the course. No complete response was observed, while partial response （PR）, stable disease （SD） and progressive disease （PD） were found in 61,33 and 29 patients,respectively, with an overall response rate （ORR） of 49. 6% and disease control rate （DCR） of 76. 4%. The median progression-free survival（mPFS） period was 10. 2 months. No significant differences in efficacy were observed among gefitinib, erlotinib, ectinib treatment groups （P〉 0. 05）. Conclusions It is safe and effective that apply gefitinib, erlotinib or ectinih in the elderly patients with advanced NSCLC, only with slight and tolerable adverse reactions.

关 键 词：表皮生长因子受体酪氨酸激酶抑制剂 晚期非小细胞肺癌 靶向治疗 老年人 

分 类 号：R734.2[医药卫生—肿瘤]