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目的探讨易瑞沙单药治疗男性、不吸烟或轻度吸烟的晚期肺腺癌患者疗效与不良反应。方法 2006年10月—2009年12月共25例男性、不吸烟或轻度吸烟的晚期肺腺癌患者接受易瑞沙250mg/d口服治疗,观察患者的疗效、TTP、MST和不良反应。结果本组25例患者均可评价疗效,其中完全缓解2例,部分缓解10例,稳定9例,进展4例。有效率为48%,疾病控制率为84%,中位TTP为285天,1年无进展生存率为32%,MST为446天,1年生存率为36%。最常见不良反应主要为皮疹和腹泻。有效率与患者性别、年龄、一般状况、分期及既往治疗无关。TTP与患者年龄及PS评分无关;与TTP相关的因素包括分期、既往治疗、腹泻。IV期较IIIB期患者进展风险高(HR=16.042,P=0.028),有放疗史的患者进展风险高(HR=5.176,P=0.018),有手术史的患者进展风险低(HR=0.091,P=0.024)。出现腹泻的患者疾病进展风险相对较小(HR=0.246,P=0.246)。结论易瑞沙治疗河南本地腺癌、不吸烟的晚期NSCLC的疗效显著,总体生存明显获益,不良反应轻微。
Objective To investigate the efficacy and adverse reactions of Iressa monotherapy in patients with advanced lung adenocarcinoma who do not smoke or mild smoking. Methods From October 2006 to December 2009, 25 male patients with advanced lung adenocarcinoma who did not smoke or mild smoking were treated with Iressa 250mg / d orally, and the curative effect, TTP, MST and adverse reactions were observed. Results The group of 25 patients can evaluate the curative effect, including complete remission in 2 cases, partial remission in 10 cases, stable in 9 cases and progression in 4 cases. The effective rate was 48%, the disease control rate was 84%, the median TTP was 285 days, the 1-year progression-free survival rate was 32%, the MST was 446 days, and the 1-year survival rate was 36%. The most common adverse reactions are mainly rashes and diarrhea. Efficacy and patient gender, age, general condition, stage and previous treatment has nothing to do. TTP was not related to patient’s age and PS score. Factors related to TTP included staging, previous treatment and diarrhea. The patients with stage IVIB had higher risk of progression (HR = 16.042, P = 0.028), patients with history of radiotherapy had higher risk of progression (HR = 5.176, P = 0.018) P = 0.024). Patients presenting with diarrhea had a relatively lower risk of developing disease (HR = 0.246, P = 0.246). Conclusion Iressa treatment of local adenocarcinoma of Henan Province, non-smoking of advanced NSCLC significant effect, overall survival obvious benefit, minor adverse reactions.