吉非替尼致間質性肺疾病二例并文獻復習_《中國呼吸與危重監護雜志》

作者：

高寶安 , 張凌云 , 陳世雄 , 向光明 , 官莉

三峽大學第一臨床醫學院宜昌市中心人民醫院呼吸內科( 湖北宜昌 443003) 通信作者: 高寶安, E-mail: gaobaoan_hubei@ 163. com;

關鍵詞：

吉非替尼間質性肺疾病治療

DOI：

DOI: 10 . 7507 /1671 -6205 . 20130123

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目的提高對吉非替尼所致間質性肺疾病診斷和治療的認識。
方法對2 例吉非替尼所致間質性肺疾病予以報道, 結合有關文獻進行回顧性分析。
結果間質性肺疾病是吉非替尼較嚴重的不良反應, 其所致肺損傷的危險因素包括高齡、吸煙史、PS gt;2、應用時已存在肺間質性疾病或肺部感染、曾用化療或放療者; 臨床上早期多表現為發熱、干咳和呼吸困難, 肺CT 多提示以雙肺彌漫性毛玻璃樣浸潤影和肺實變為主; 大多在應用1 個月內發生, 進展迅速; 治療上以激素為主, 輔以抗感染和無創呼吸支持治療, 可在短時間內控制病情。
結論吉非替尼所致間質性肺疾病是臨床上嚴重的不良反應, 激素治療輔以無創呼吸支持可有效緩解病情。

引用本文： 高寶安,張凌云,陳世雄,向光明,官莉. 吉非替尼致間質性肺疾病二例并文獻復習. 中國呼吸與危重監護雜志, 2013, 12(5): 513-515. doi: DOI: 10 . 7507 /1671 -6205 . 20130123 復制

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1. Suzuki M, Asahina H, Konishi J, et al. Recurrent gefitinibinduced interstitial lung disease. Intern Med, 2008, 47 : 533-536.
2. Kuo LC, Lin PC, Wang KF, et al. Successful treatment of gefitinib-induced acute interstitial pneumonitis with high-dose corticosteroid: a case report and literature review. Med Oncol,2011, 28 : 79 -82.
3. Kitajima H, Takahashi H, Harada K, et al. Gefitinib-induced interstitial lung disease showing improvement after cessation:disassociation of serum markers. Respirology, 2006 , 11: 217 -220.
4. Brehmer D, Greff Z, Godl K, et al. Cellular targets of gefitinib.Cancer Res, 2005 , 65: 379 -382.
5. Mok TS, Wu YL, Thongprasert S, et al. Gefitinib or carboplatinpaclitaxel in pulmonary adenocarcinoma. N Engl J Med, 2009 ,361: 947-957.
6. Maemondo M, Inoue A, Kobayashi K, et al. Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR. N Engl J Med, 2010, 362: 2380-2388.
7. Suzuki H, Aoshiba K, Yokohori N, et al. Epidermal growth factor receptor tyrosine kinase inhibition augments a murine model of pulmonary fibrosis. Cancer Res, 2003, 63: 5054-5059.
8. Harada C, Kawaguchi T, Ogata-Suetsugu S, et al. EGFR tyrosine kinase inhibition worsens acute lung injury in mice with repairing airway epithelium. Am J Respir Crit Care Med, 2011, 183: 743 -.
9. Ando M, Okamoto I, Yamamoto N, et al. Predictive factors for interstitial lung disease, antitumor response, and survival in nonsmall-cell lung cancer patients treated with gefitinib. J Clin Oncol,.
10. Kudoh S, Kato H, Nishiwaki Y, et al. Interstitial lung disease in Japanese patients with lung cancer: a cohort and nested case-control study. Am J Respir Crit Care Med, 2008 , 177 : 1348 -1357 .
11. Cohen MH, Williams GA, Sridhara R, et al. United States Food and Drug Administration Drug Approval summary: Gefitinib ( ZD1839 ; Iressa ) tablets. Clin Cancer Res, 2004, 10: 1212 -1218.
12. Seto T, Seki N, Uematsu K, et al. Gefitinib-induced lung injury successfully treated with high-dose corticosteroids. Respirology,2006, 11 : 113-116.
13. 高寶安, 丁琳, 詹慶元, 等. 無創正壓通氣治療急性低氧性呼吸衰竭前瞻性隊列研究. 中國危重病急救醫學, 2009, 21: 579 -582.
14. Chang SC, Chang CY, Chen CY, et al. Successful erlotinib rechallenge after gefitinib-induced acute interstitial pneumonia. J Thorac Oncol, 2010, 5: 1105-1106.
15. Fukui T, Otani S, Hataishi R, et al. Successful rechallenge with erlotinib in a patient with EGFR-mutant lung adenocarcinoma who developed gefitinib-related interstitial lung disease. CancerChemother Pharmacol, 2010 , 65: 803-806.
16. Dallas JL, Jantz MA, Lightsey JL, et al. Successful erlotinib rechallenge after erlotinib-induced interstitial lung disease. J Thorac Oncol, 2011, 6: 1142-1143.
17. .
18. , 24 : 2549 -2556.

《中國呼吸與危重監護雜志》

吉非替尼致間質性肺疾病二例并文獻復習

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《中國呼吸與危重監護雜志》

吉非替尼致間質性肺疾病二例并文獻復習

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