摘要
目的观察对常规剂量获得性耐药的肺腺癌患者接受更高每日剂量吉非替尼治疗的疗效与安全性。方法收集加14年1月至2015年12月对吉非替尼常规剂量（250mg／d）获得性耐药的2l例肺腺癌患者，增加剂量至500mg／d进行治疗，评价近期疗效及不良反应。对吉非替尼增量治疗有效的患者给予有效的剂量继续治疗直至出现疾病进展或出现不可耐受的不良反应，观察无进展生存期。对吉非替尼增量治疗1个月后依然进展的患者，改用化疗或接受常规剂量吉非替尼治疗。结果2l例对常规剂量吉非替尼获得性耐药的肺腺癌患者，经剂量增至500mg／d治疗后，4例患者部分缓解（PR），2例疾病稳定（SD），疾病控制率（DCR=PR＋SD）为28．6％（6／21），中位无进展生存期2．5个月。不良反应均为1～2级，主要表现为皮疹、腹泻、纳差、皮肤干燥和乏力等。结论对于常规剂量吉非替尼获得性耐药的肺腺癌患者，吉非替尼增量治疗安全有效，值得临床进一步研究应用。
Objective To observe the efficacy and safety of elevated daily dose of gefitinib for patients with advanced lung adenocarcinomas who acquired resistance to conventional dose of gefifinib. Methods Twenty -one patients with advanced lung adenocarcinomas who acquired resistance to con- ventional dose of gefitinib （250 rag/d） were recruited in this study from January 2014 to December 2015. All of the patients received gefitinib 500 mg/d for 1 month, then short term efficacy and adverse reactions were observed. For patients who responded to elevated daily dose of gefitinib, treatment continued till disease progression or development of intolerable toxicity, and progression - free survival （PFS） were ob- served. Patients who progressed at elevated dose of gefitinib, were treated by chemotherapy or received conventional dose of gefitinib. Results After elevated dose of gefitinib 500 mg/d treatment, there were 4 cases of PR, 2 cases of SD, the disease control rate （DCR） was 28.6%, the median PFS was 2. 5 months. Adverse reactions were all in grade 1-2, such as rash, diarrhea, anorexia, dry skin and fatigue. Conclusions For a portion of patients with advanced lung adnocarcinomas who acquired resist- ance to conventional dose of gefitinib, elevated dose of gefitinib treatment is a safe and efficient choice, deserving further clinical practice and study.
出处
《中国实用医刊》
2016年第23期13-15,共3页
Chinese Journal of Practical Medicine
