吉非替尼治療突變未知的終末期非小細胞肺癌的臨床觀察_《華西醫學》

作者：

劉定義 ,  朱麗 , 張繼良 , 劉鴻

成都市腫瘤醫院腫瘤內科（成都，610021）;

關鍵詞：

肺癌吉非替尼突變未知生活質量

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【摘要】目的 評估吉非替尼治療終末期（PS評分≥3分）非小細胞肺癌（NSCLC）的臨床效果和生活質量改善情況。方法 2008年5月-2010年6月共收治終末期NSCLC患者40例，其中19例患者采用吉非替尼治療（治療組），21例采用支持治療+中藥治療（對照組）。結果治療6個月后，治療組19例患者中，CR 1例，PR 5例，SD 10例，PD 3例。治療組有效率為31.5%（6/19），臨床受益率為84.2%（16/19）。對照組21例中，SD 5例，PD 16例，無CR。對照組有效率為23.8%（5/21），臨床受益率為 23.8%（5/21）。兩組間有效率和臨床受益率比較，差異均有統計學意義（P lt;0.05）。治療組中位生存期為13.2個月，對照組中位生存期為4.5個月。結論吉非替尼可延長NSCLC患者的生存期，改善其生活質量。
【Abstract】 Objective To evaluate the curative effect and life improvement of gefitinib on non-small cell lung cancer (NSCLC) which in the end stage. Methods Forty patients with end-stage NSCLC were treated from May 2008 to June 2010. Nineteen patients of them were treated with gefitinib (treatment group), 21 patients were treated with supportive care and traditional Chinese medicine treatment (control group). Results Six months after treatment, there are one patient with CR, five patients with PR, 10 patients with SD and three patients with PD in the treatment group. The effective rate of treatment group was 31.5% (6/19), clinical benefit rate was 84.2% (16/19). There are five patients with SD, 16 patients with PD, and no one with CR in the control group. The effective rate of the control group was 23.8% (5/21), clinical benefit rate was 23.8% (5/21). The differences of effective rate and clinical benefit rate between two groups were statistically significant (P lt;0.05). The median survival period of the treatment group and control group were 13.2 and 4.5 months respectively. Conclusion Gefitinib can extend the lifetime of NSCLC patients and improve their quality of life.

引用本文： 劉定義,朱麗,張繼良,劉鴻. 吉非替尼治療突變未知的終末期非小細胞肺癌的臨床觀察. 華西醫學, 2010, 25(8): 1423-1425. doi: 復制

1.	孫燕, 石遠凱. 臨床腫瘤內科手冊[M]. 北京: 人民衛生出版社, 2008: 388-424.
2.	韓寶惠. 從靶向治療看非小細胞肺癌患者的生活質量[J]. 中國肺癌雜志, 2009, 6(6): 615-616.
3.	Saijo N, Takeuchi M, Kunitoh H. Reasons for response differences seen in the V 15-32 INTEREST and IPASS trials[J]. Nat Rey Clin Onco, 2009, 6(5): 287-294.
4.	Sanford M, Scott LJ. Gefitinib a review of its use in the treatm ent of locally advanced/m etastatic non-small cell lung cancer[J]. Drugs, 2009, 69(16): 2303-2328.
5.	Ebi N, Semba H, Tokunaga SJ, et al. A phase Ⅱ trial of gefitinib monotherapy in chem. Otherapy-nave patients of 75 years or olderw ith advanced non-small cell lung cancer[J]. J Thorac Onco, 2008, 3(10): 1166-1171.
6.	鮑云華, 李儉杰. 介紹新的實體瘤治療反應評價標準(RECIST) [J]. 中國肺癌雜志, 2005, 8(1): 77-78.
7.	周清華, 王瑾, 許峰, 等. 2005年美國國家綜合癌癥網(NCCN)非小細胞肺癌臨床指南[J]. 中國肺癌雜志, 2005, 8(4): 332-346.
8.	Inoue A, Kobayashi. First-line gefitin ib for patients withadvanced non-snall lung cancer harboring eprdemal grow th factor receptor mutations without indication for chemotherapy[J]. J ClimOncoj, 2009, 27(9): 1350-1354.
9.	Fischer JR, GeigerD. Successful individualized and targeted therapy of an NSCLC patient with Gefitinib based on a predictive assessm ent of the EGF-receptormutation status [J]. Pneumologie, 2007, 61(4): 264-269.
10.	Yoshida K, Yatabe Y, Park JY, et al. Prospective validation for prediction of gefitinib sensitivity by epidemalgrow th factor receptor gene mutation in patients with non-small cell lung cancer[J]. J Thorac Oncol, 2007, 2(1): 22-28.
11.	Varella-Garcia M, Mitsudami T, Yatabe Y, et al. EGFR and HER2 genam ic gain in recurrent non-small cell lung cancer after sungery im pact on outcame to treatment with gefitinib and association with EGFR and KRAS mutations in a Japanese cohort [J]. J Thorac Onco, 2009, 4(3): 318-325.
12.	楊衿記, 吳一龍. 先睹為快[J]. 循證醫學, 2009, 8(4): 66.
13.	Wu YL, Zhong WZ, Li LY, et al. Epiderm al grow th factor receptor mutations and their correlation with grfitinib therapy in patients with non-small cell lung cancer ameta-analysis based on updated individual patient data from six medical centers in mainland China[J]. J Thorac Oncol, 2007, 2(5): 430-439.

1. 孫燕, 石遠凱. 臨床腫瘤內科手冊[M]. 北京: 人民衛生出版社, 2008: 388-424.
2. 韓寶惠. 從靶向治療看非小細胞肺癌患者的生活質量[J]. 中國肺癌雜志, 2009, 6(6): 615-616.
3. Saijo N, Takeuchi M, Kunitoh H. Reasons for response differences seen in the V 15-32 INTEREST and IPASS trials[J]. Nat Rey Clin Onco, 2009, 6(5): 287-294.
4. Sanford M, Scott LJ. Gefitinib a review of its use in the treatm ent of locally advanced/m etastatic non-small cell lung cancer[J]. Drugs, 2009, 69(16): 2303-2328.
5. Ebi N, Semba H, Tokunaga SJ, et al. A phase Ⅱ trial of gefitinib monotherapy in chem. Otherapy-nave patients of 75 years or olderw ith advanced non-small cell lung cancer[J]. J Thorac Onco, 2008, 3(10): 1166-1171.
6. 鮑云華, 李儉杰. 介紹新的實體瘤治療反應評價標準(RECIST) [J]. 中國肺癌雜志, 2005, 8(1): 77-78.
7. 周清華, 王瑾, 許峰, 等. 2005年美國國家綜合癌癥網(NCCN)非小細胞肺癌臨床指南[J]. 中國肺癌雜志, 2005, 8(4): 332-346.
8. Inoue A, Kobayashi. First-line gefitin ib for patients withadvanced non-snall lung cancer harboring eprdemal grow th factor receptor mutations without indication for chemotherapy[J]. J ClimOncoj, 2009, 27(9): 1350-1354.
9. Fischer JR, GeigerD. Successful individualized and targeted therapy of an NSCLC patient with Gefitinib based on a predictive assessm ent of the EGF-receptormutation status [J]. Pneumologie, 2007, 61(4): 264-269.
10. Yoshida K, Yatabe Y, Park JY, et al. Prospective validation for prediction of gefitinib sensitivity by epidemalgrow th factor receptor gene mutation in patients with non-small cell lung cancer[J]. J Thorac Oncol, 2007, 2(1): 22-28.
11. Varella-Garcia M, Mitsudami T, Yatabe Y, et al. EGFR and HER2 genam ic gain in recurrent non-small cell lung cancer after sungery im pact on outcame to treatment with gefitinib and association with EGFR and KRAS mutations in a Japanese cohort [J]. J Thorac Onco, 2009, 4(3): 318-325.
12. 楊衿記, 吳一龍. 先睹為快[J]. 循證醫學, 2009, 8(4): 66.
13. Wu YL, Zhong WZ, Li LY, et al. Epiderm al grow th factor receptor mutations and their correlation with grfitinib therapy in patients with non-small cell lung cancer ameta-analysis based on updated individual patient data from six medical centers in mainland China[J]. J Thorac Oncol, 2007, 2(5): 430-439.

《華西醫學》

吉非替尼治療突變未知的終末期非小細胞肺癌的臨床觀察

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《華西醫學》

吉非替尼治療突變未知的終末期非小細胞肺癌的臨床觀察

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