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目的探讨应用吉非替尼(IRESSA)治疗晚期非小细胞肺癌(NSCLC)患者的疗效及其对生活质量的影响。方法既往化疗失败的Ⅲb-Ⅳ期NSCLC患者41例,其中二线化疗失败者占85.4%(35/41)。IRESSA 250 mg口服,每日1次,服药至病情进展或出现不能耐受的不良反应。患者分别在治疗后1个月、2个月和以后每3个月复查。结果本组41例患者均可评价疗效,其中PR 18例,SD 14例,PD 9例,有效率为43.9%(18/41),疾病控制率(PR+SD)为78.0%(32/41)。男性患者和女性患者的有效率分别为42.1%和45.5%(P>0.05)。至随访结束,41例患者中,有22例(53.7%)存活,其中位生存时间(MST)为10.1个月;19例死亡患者的疾病进展时间(TTP)为2.7个月,MST为5.0个月;PR患者的MST为13.3个月。全组患者症状改善率为78.0%。服药28 d,KPS评分提高20±5分,无Ⅲ-Ⅳ度毒性反应。结论IRESSA单药对化疗失败的晚期NSCLC疗效确切,并可用于一般状况评分较差的患者,其不良反应轻,是二三线用药的良好选择。
Objective To investigate the curative effect and quality of life of patients with advanced non-small cell lung cancer (NSCLC) treated with gefitinib (IRESSA). Methods Totally 41 patients with stage Ⅲb-Ⅳ NSCLC who had failed previous chemotherapy were included, of whom 85.4% (35/41) failed second-line chemotherapy. IRESSA 250 mg orally, once daily, until the disease progresses or intolerable adverse reactions. Patients were reviewed at 1 month, 2 months, and every 3 months after treatment. Results Eighteen cases of PR, 14 cases of SD and 9 cases of PD had an effective rate of 43.9% (18/41) and a disease control rate (PR + SD) of 78.0% (32/41) ). The effective rates of male patients and female patients were 42.1% and 45.5%, respectively (P> 0.05). At the end of follow-up, 22 (53.7%) of 41 patients survived with a median survival time (MST) of 10.1 months; 19 patients had a disease progression time (TTP) of 2.7 months and MST of 5.0 Month; PR patients MST was 13.3 months. The symptom improvement rate of all patients was 78.0%. 28 d medication, KPS score increased 20 ± 5 points, no Ⅲ-Ⅳ degree toxicity. Conclusion The single-agent IRESSA is effective in the treatment of advanced NSCLC with failed chemotherapy and can be used in patients with poor general condition score. The adverse reactions are mild and it is a good choice for second- and third-line treatment.