吉非替尼对EGFR敏感突变肺腺癌脑转移患者的预后影响  

Effect of Gefitinib on Survival of Patients with Lung Adenocarcinoma of Sensitive EGFR Mutation

作　　者：赵峰[1] 苗怡然[1] 曹生亚[1] ZHAO Feng;MIAO Yi-ran;CAO Sheng-ya(X uZhou Cancer Hospital ,Xuzhou 221005, China)

机构地区：[1]徐州市肿瘤医院

出　　处：《肿瘤学杂志》2018年第3期221-225,共5页Journal of Chinese Oncology

摘　　要：[目的]了解吉非替尼在EGFR敏感突变肺腺癌脑转移患者中的生存情况,进一步分析临床、影像及药物动力学等因素对预后有无影响。[方法]37例初治EGFR敏感突变肺腺癌脑转移患者口服吉非替尼250mg/d,服用吉非替尼一月后检测血药及脑脊液药物浓度,病情进展后联合化疗或全脑放疗。[结果]8例患者病情稳定,29例肿瘤进展;无进展生存期为2.1~16月,中位无进展生存期6.2月;总生存期为2.1~21.9月,中位生存期8.7月。吉非替尼血药浓度、脑脊液浓度及脑脊液通透率与无进展生存期、总生存期均有正相关性,其中脑脊液浓度的相关性最大。在多种预后因素中,颅内病灶能否控制对无进展生存期及总生存期的影响具有统计学意义。[结论]吉非替尼明显改善了EGFR敏感突变肺腺癌脑转移患者的无进展生存期及总生存期,颅内病灶有效控制是改善患者预后的重要因素。[Objective]To investigate the effect of gefitinib on survival of patients with lung adenocarcinoma of sensitive EGFR mutation.[Methods]Thirty seven patients with lung adenocarcinoma of sensitive EGFR mutation and brain metastasis were treated with gefitinib 250 mg/d in the initial treatment.The drug concentrations in plasma and cerebrospinal fluid（CSF）were detected 1 month after medication.For those with disease progression,chemotherapy or whole brain radiotherapy were given.[Results]Eight patients were in stable condition and 29 cases had tumor progression.The progress-free survival（PFS）was 2.1 to 16 months with a median PFS of 6.2 months.The overall survival（OS）was 2.1 to 21.9 months with a median OS of 8.7 months.The blood and CSF drug concentration and CSD permeability were positively correlated with PFS and OS of patients;and the control of intracranial lesions was also associated with PFS and OS.[Conclusion]Gefitinib significantly improves PFS and OS of patients with lung adenocarcinoma of EGFR sensitive mutation and brain metastasis.Effective control of intracranial lesions is an important factor to improve the prognosis of patients.

关 键 词：非小细胞肺癌 脑转移 表皮生长因子受体络氨酸激酶抑制剂 药代动力学 

分 类 号：R734.2[医药卫生—肿瘤]