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目的观察吉非替尼单药治疗晚期非小细胞肺癌(NSCLC)的疗效和不良反应。方法对50例晚期NSCLC患者给予吉非替尼250 mg／d口服治疗,观察疗效和不良反应,采用欧洲癌症研究和治疗组织生活质量调查核心问卷QLQ-C30和简明乏力量表(BFI)对患者的生活质量及临床症状的改善进行评价,观察疾病进展时间(TTP)和中位生存时间(MST)。结果50例晚期NSCLC患者中,无完全缓解者,部分缓解(PR)8例(16．0％),临床获益率为60．0％,临床获益率与性别、病理类型及吸烟史有关。到随访截止日期,50例患者中,20例(40．O％)存活,其MST为13个月;30例死亡患者TTP为5个月,MST为6个月。PR患者MST为9个月。综合生活质量改善率为58．0％,乏力症状缓解率为52．6％,出现症状缓解的中位时间为15 d。不良反应主要为Ⅰ、Ⅱ度皮疹和腹泻,对症处理后可缓解。3例既往因放疗而引起放射性肺炎的患者中,2例放射性肺炎加重。结论吉非替尼有明显抗肿瘤作用,能明显提高晚期NSCLC患者的生活质量,改善临床症状,不良反应可以耐受。
Objective To observe the efficacy and side effects of gefitinib monotherapy in the treatment of advanced non-small cell lung cancer (NSCLC). Methods 50 patients with advanced non-small cell lung cancer (NSCLC) were treated with gefitinib 250 mg / d orally, and the curative effect and adverse reactions were observed. The QLQ-C30 and BFI were used in the study. The quality of life and improvement of clinical symptoms were evaluated. The time to progression (TTP) and median survival time (MST) were observed. Results In 50 patients with advanced NSCLC, there were 8 patients (16.0%) with partial remission (PR) and 60.0% clinical benefit rate. The clinical benefit rate was related to sex, pathological type and smoking history . By the deadline for follow-up, 20 (40.0%) of the 50 patients survived with an MST of 13 months; the 30 patients who died were TTP of 5 months and MST of 6 months. PR patients MST for 9 months. The overall quality of life improvement rate was 58.0%, the fatigue rate was 52.6%, and the median time to symptom relief was 15 days. Adverse reactions mainly Ⅰ, Ⅱ rash and diarrhea, symptomatic treatment can be alleviated. Of the 3 patients previously diagnosed with radiation pneumonitis due to radiotherapy, 2 were exacerbated by radiation pneumonitis. Conclusion Gefitinib has obvious anti-tumor effects, can significantly improve the quality of life of patients with advanced NSCLC, improve clinical symptoms, adverse reactions can be tolerated.