摘要
目的：探讨化学治疗交替吉非替尼一线治疗表皮生长因子受体（EGFR）突变阳性的晚期非小细胞肺癌的临床疗效及安全性。方法选取40例初诊的 EGFR 突变阳性的非小细胞肺癌晚期患者，分别于疗程的第1、8日予吉西他滨1000 mg／m2、第1日予顺铂75 mg／m2或卡铂 AUC 5、第15～28日予吉非替尼250 mg／d，每28 d 为1个周期，根据患者病情行4～6个周期的化学治疗，然后患者继续口服吉非替尼250 mg／d 至疾病进展或出现难以耐受的不良反应。观察治疗效果及毒副反应。结果入组的40例患者中位无进展生存期为17（10～29）个月，中位总生存期为30（22～41）个月；客观缓解率为85％（0例完全缓解，34例部分缓解）。不良反应大多属于Ⅰ～Ⅱ度，以贫血、中性粒细胞减少、恶心、呕吐及皮疹为主。结论化学治疗交替吉非替尼治疗 EGFR 突变阳性晚期非小细胞肺癌的疾病缓解率较高，且不良反应程度较轻。
Objective To evaluate the clinical efficacy and safety of alternate chemotherapy with first-line gefitinib in treating advanced non-small cell lung cancer with positive mutation of epidermal growth factor receptor （EGFR）.Methods Forty patients first diagnosed with advanced non-small cell lung cancer with positive EGFR mutation were enrolled.They were scheduled to receive gemcitabine at a dose of 1 000 mg/m2 on days 1 and 8,cisplatin 75 mg/m2 or carboplatin AUC 5 on day 1 and gefitinib 250 mg/day from days 1 5 to 28.One cycle of therapy endured for 28 days.After 4 ～6 cycles of chemotherapy based upon individual situ-ation,gefitinib was administered orally at a dose of 250 mg/day until disease progression or intolerable toxicity occurred.Clinical efficacy and toxicity were observed.Results The median progression-free survival （PFS） of the 40 patients was 1 7 months （range 1 0-29 months）and the median overall survival （OS）was 30 months （range 22-41 months）.The objective response rate was 85% （no case with complete remission and 34 with partial remission）.A majority of toxicities were grade I-II,mainly including anemia,neutropenia,nausea, vomiting and rash.Conclusion Alternate chemotherapy with first-line gefitinib yielded high remission rate and mild toxic responses in treating advanced non-small cell lung cancer with positive mutation of EGFR.
出处
《新医学》
2015年第6期391-394,共4页
Journal of New Medicine
关键词
晚期非小细胞肺癌
EGFR突变阳性
吉西他滨
顺铂
卡铂
吉非替尼
Advanced non-small cell lung cancer
Positive mutation of EGFR
Gemcitabine
Cisplatin
Carboplatin
Gefitinib
