化疗间期序贯应用厄洛替尼治疗晚期非小细胞肺癌的临床观察

医学

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化疗间期序贯应用厄洛替尼治疗

晚期非小细胞肺癌的临床观察

200030　上海　上海交通大学附属胸科医院上海市肺部肿瘤临床医学中心

宋正波,陆　舜,虞永峰,李子明,廖美琳,陈智伟

1

　　【摘　要】　目的　LC。方法　

初治或复治的局部晚期或晚期NSCLC患者共39例,14例方案为多西他赛或培美曲塞,化疗间歇期序贯给予厄洛替尼(,～d28),16周期,直至疾病进展或毒副反应不能耐受。结果　39,3146个周期。所有患者均可进行疗效评价,其中获PR9例

(初治7例),SD23例(),(初治2例)。总体客观缓解率(RR)为2311%,其中初治RR为2810%(7/25),复

治RR1413%(2/14),(DCR)为8211%,初治患者为9210%,复治患者6413%。主要不良反应为皮疹和血液系统毒性。结论　化疗序贯厄洛替尼治疗NSCLC近期疗效较好,毒副反应可耐受,远期疗效有待进一步观察。

　　【关键词】　非小细胞肺癌;　化学治疗;　厄洛替尼

中图分类号:R73412　　文献标识码:A　　文章编号:1009-0460(2010)01-0048-04

Sequentialerlotinibincombinationwithchemotherapyinthetreatmentofadvancednon2smallcelllungcancer

　　SONGZheng2bo,LUShun,YUYong2feng,LIZi2ming,LIAOMei2lin,CHENZhi2wei.ShanghaiLungTumor

ClinicalMedicalCenter,theAffiliatedChestHospitaltoShanghaiJiaotongUniversity,Shanghai200030,China　　Correspondingauthor:CHENZhi2wei,E2mail:chenzhiwei@gmail.com

【Abstract】　Objective　Thisstudyinvestigatedwhethersequentialadministrationoferlotinibandchemotherapyimprovedob2　　

jectiveresponserateandsideeffectsinpatientswithadvancednon2smallcelllungcancer(NSCLC).Methods　Previouslytreatedoruntreatedpatients(n=39)withstageⅢB/ⅣNSCLCwerereceivedeithererlotinib(150mg/day)ondays15228ofa42weekcyclethatincludedgemcitabineintheinitialpatientsanddoeocetaxelorpemetrexedintheretreatedpatients,eitheraswellascisplatinorcarbo2platin.Theprimaryendpointwastumorresponserateandsafety.Results　Thirty2nineadvancedNSCLCpatientswasretrospectivelyreviewed.Among39patients,25wastreatedasthefirst2linetherapy,14wassecondorthird2line.Onehundredandthirty2fivecycleswerefinished,theaveragecyclewas3146.In39patientsnocompleteregressionwasobserved,9hadpartialresponse(PR),and23stabledisease(SD),while7hadprogressofdisease(PD).Theoveralldiseasecontrol(PR+SD)was8211%,thetotalresponseratewas2311%.Mostofthesideeffectswererashandhematologictoxicity.Conclusion　Sequentialadministrationoferlotinibandchem2otherapyinNSCLCiseffectiveinashorttime,thetoxicitycanbewelltolerated.Thelongeffectshouldbeobserved.

【KeyWords】　Non2smallcelllungcancer;　Chemotherapy;　Erlotinib　　

　　肺癌是人类最常见的肿瘤之一,其中非小细胞肺癌(NSCLC)约占80%～85%。大约30%～40%的NSCLC在诊断时即属于晚期,失去了手术切除的机会。含铂方案是目前晚期NSCLC一线标准治疗方案,但仅能使Ⅲ～Ⅳ期NSCLC的死亡风险下降

1　通讯作者,E2mail:chenzhiwei@gmail.com

26%～32%。近年来随着分子生物学技术的进步,

肿瘤治疗深入到分子领域,肿瘤治疗已经进入靶向

治疗时代,表皮生长因子受体酪氨酸激酶抑制剂(EGFR2TKI)的代表药物吉非替尼和厄洛替尼已经成为目前二线治疗标准药物,且其疗效明显,已有研