厄洛替尼治疗吉非替尼耐药老年非小细胞肺癌脑转移的疗效

目的 观察厄洛替尼治疗吉非替尼耐药老年非小细胞肺癌(non-small cell lung cancer,NSCLC)脑转移的疗效及不良反应,评价生活质量.方法 41例老年NSCLC脑转移患者分为吉非替尼组(21例)和厄洛替尼组(服吉非替尼曾经有效耐药后改服厄洛替尼,20例).服吉非替尼250 mg/d或服厄洛替尼150 mg/d;直到疾病进展、死亡或发生不可耐受的不良反应.观察临床疗效、不良反应及评价生活质量.结果 吉非替尼组有效率14.3％(3/21)稍高于厄洛替尼组10.0％ (2/20),两组比较差异无统计学意义(P＞0.05).吉非替尼组疾病控制率38.1％(8/21)稍高于厄洛替尼组30.0％(6/20),两组比较差异无统计学意义(P＞0.05).吉非替尼组Karnofsky评分提高+稳定者57.1％(12/21)、厄洛替尼组25.0％(5/20),吉非替尼组生活质量改善高于厄洛替尼组(P＜0.05)；吉非替尼组不良反应发生率低于厄洛替尼组(P＜0.05).两组2年生存率比较差异无统计学意义(P＞0.05).结论 吉非替尼及厄洛替尼均可作为治疗老年NSCLC脑转移的治疗选择,服用吉非替尼曾经有效的患者改服厄洛替尼30％病情可得到控制,但吉非替尼耐药后再服用厄洛替尼患者不良反应发生率较高.

Erlotinib effect after gefitinib failure on aged patients with brain metastases from non-small cell lung cancer

Objective To evaluate the short-term efficacy,toxicity and quality of life erlotinib on the aged brain metastases from non-small cell lung cancer(NSCLC).Methods A total of 41 patients were randomly divided into gefitinib group(n=21) and erlotinib group(n=20,patients received erlotinib after disease progression or intolerable toxicity by taking gefitinib).The patients received erlotinib 150 mg daily or gefitinib 250 mg daily.The efficacy and adverse effects of two groups were observed.Results The effective rate of erlotinib group was higher than that of gefitinib group,14.3%(3/21) vs 10.0%(2/20),but it showed no statistic significance(P>0.05).The disease control rate of erlotinib group was also higher than that of gefitinib group,38.1%(8/21)vs 30.0%(6/20) without statistic significance(P>0.05).Karnofsky score in improvement with stableness in gefitinib group was 57.1%(12/21),that in erlotinib group 25.0%(5/20),the quality of life in gefitinib group was significantly higher than that in erlotinib group(P<0.05).The adverse reactions of erlotinib group were lower than those of gefitinib group(P<0.05).The two-year survival rate showed no statistic significance between two groups(P>0.05).Conclusion Both gefitinib and erlotinib are choices in treatment on NSCLC.30% of the patients who once received erlotinib then changed to taking gefitinib can control the disease after disease progression or intolerable toxicity,but more side effects and adverse reaction are observed in patients of erlotinib group.