吉非替尼单药治疗晚期非小细胞肺癌老年患者的临床分析

目的观察吉非替尼单药治疗对晚期非小细胞肺癌(NSCLC)老年患者的效果和安全性。方法采用吉非替尼(250 mg/d)对87例65岁以上的ⅢB～Ⅳ期NSCLC患者进行治疗,直至病变进展或出现不可耐受的不良反应。结果治疗总有效率为31.0%(27/87);疾病控制率为77.0%(67/87);中位无疾病进展生存时间(PFS)为6.6个月,中位总生存时间为12.3个月;1年生存率为52.9%。腺癌和既往未接受化疗患者的治疗有效率和疾病控制率显著高于非腺癌和既往接受化疗的患者(P<0.05);女性和非吸烟患者的疾病控制率显著高于男性和吸烟患者(P≤0.01)。体能状态ECOG评分0～1、腺癌、非吸烟和吉非替尼治疗有效患者的中位PFS明显优于ECOG评分≥2、非腺癌、吸烟和吉非替尼治疗无效患者(P<0.01);ECOG评分0～1和吉非替尼治疗有效的患者的中位生存时间明显优于ECOG评分≥2和吉非替尼治疗无效患者(P≤0.001)。吉非替尼单药治疗最常见的不良反应为皮疹(56.3%)和腹泻(36.8%)。结论对于晚期NSCLC的老年患者,吉非替尼单药治疗有效且安全,其不良反应均可耐受。     

吉非替尼治疗晚期非小细胞肺癌的临床分析

目的 观察吉非替尼治疗晚期非小细胞肺癌(NSCLC)的临床疗效及安全性.方法 回顾性分析30例接受吉非替尼治疗的NSCLC患者的临床资料,评估其临床疗效及不良反应的发生情况.结果 30例入组患者中,1例达到CR,8例PR,12例SD,9例PD,有效率为30％(9/30),疾病控制率70％(21/30);皮疹发生率为43.3％(13/30),腹泻发生率为16.7％(5/30),均为Ⅰ～Ⅱ.结论 吉非替尼治疗晚期NSCLC有较好的疗效,安全性高.     

吉非替尼治疗晚期非小细胞肺癌临床观察

目的观察表皮生长因子受体蛋白酪氨酸激酶抑制剂吉非替尼与多西紫衫醇治疗晚期非小细胞肺癌患者的疗效、毒副反应以及对生存质量影响。方法54例晚期非小细胞肺癌分为实验组（甲）,对照组（乙）。甲组为贵州省人民医院肿瘤科和遵义医学院附属医院肿瘤科24例经病理学或细胞学确诊的、化疗失败的晚期NSCLC患者,给药方式为口服吉非替尼250mg／次,1次／d;乙组为随机抽取30例同期的贵州省人民医院肿瘤科晚期肺癌二线化疗患者,予多西紫衫醇40mg／m。d（d1、d8、d15）静滴,28d为1周期。2组患者治疗中若出现肿瘤进展或出现严重的毒性反应均终止用药。结果近期疗效,甲组24例中可评价的16例的有效率（CR＋PR）3／16（18．8％）,临床获益率（CR＋PR＋SO）9／16（56．3％）;乙组有效率为20．0％,临床获益率为46．7％。药物的不良反应,甲组多见为皮疹、腹泻、恶心、皮肤干燥,多数能耐受无需治疗;乙组多见为不同程度的骨髓抑制,消化道反应,周围神经毒性,肝脏毒性,脱发等。结论初步观察结果显示：甲组和乙组治疗晚期非小细胞肺癌在疗效上无明显差异,但甲组不良反应明显少于乙组,并且其不良反应轻微,耐受性比较好,大大改善了患者的生活质量。     

吉非替尼治疗晚期非小细胞肺癌的临床观察

目的观察吉非替尼治疗晚期非小细胞肺癌（NSCLC）的临床疗效和毒副反应。方法39例晚期NSCLC患者每日均121服吉非替尼250mg,直至病情进展或患者不能耐受时停药。结果39例患者中CR0例,PR12例（30.8％）,有效率（CR＋PR）30.8％,SD15例（38.5％）,疾病控制率（CR＋PR＋SD）69.2％,1年生存率25.6％。最常见的毒副作用为皮疹18例（46.2％）、皮肤干燥11例（28.2％）和腹泻8例（20.5％）。结论吉非替尼治疗晚期NSCLC效果好,安全。     

吉非替尼治疗晚期非小细胞肺癌临床观察

目的 观察吉非替尼治疗晚期非小细胞肺癌患者的近期疗效和毒性反应.方法 23例晚期非小细胞肺癌进入本研究.吉非替尼剂量为250 mg/次,口服,1次/d.全组服药的平均时间为6.13个月.结果 毒副作用主要为皮疹9例(40.91%);腹泻3例(13.64%),1例因腹泻严重而停药;转氨酶升高1例(4.51%).22例患者参与疗效评价,治疗后获完全缓解1例,部分缓解5例,稳定12例,进展4例.全组有效率为27.27%,疾病控制率为81.82%.结论 吉非替尼在晚期非小细胞肺癌的治疗中有一定的疗效和良好的耐受性.     

吉非替尼治疗晚期小细胞肺癌临床观察

目的：观察吉非替尼（易瑞莎）治疗非小细胞肺癌的疗效及不良反应。方法：48例经放化疗失败的非小细胞肺癌患者进入本研究,口服吉非替尼250毫克,每天1次。全组服药的中位时间为6个月。按照WHO标准统一评价疗效和不良反应。结果：48例可评价病例中,获得CR 1例（2.1％）,PR 13例（27.1％）,RR（CR＋PR）14例（29.2％）,SD 16例（33.3％）,疾病控制率为62.5％,PD 18例（37.5％）,生存期4-30个月,中位生存期（MST）10个月,1年生存率45.8％,主要不良反应是皮疹,共发生30例,占全组的62.5％,其它不良反应有腹泻、恶心、口腔溃疡,无一例因不良反应退出。结论：吉非替尼治疗晚期NSCLC有效,是一种有效且具有良好耐受性的治疗药物;     

吉非替尼治疗老年晚期非小细胞肺癌的临床观察

目的观察吉非替尼治疗老年晚期非小细胞肺癌的疗效与毒副反应。方法选取26例经病理学诊断的老年晚期(Ⅲb期或Ⅳ期)非小细胞肺癌患者入组,单药口服吉非替尼250mg每日1次。评价其疗效及不良反应。结果26例患者中CR1例,PR8例,SD10例,PD7例;疾病控制率73.1%。随访4～36个月,中位随访17个月,中位生存期14.4个月(6.5～27.3个月),中位无进展生存11.5个月(5～16.5个月)。不良反应以皮疹、腹泻、转氨酶升高、恶心呕吐为主,多为轻度。结论吉非替尼治疗老年晚期非小细胞肺癌有较好的有效性和安全性。     

吉非替尼治疗晚期复治的非小细胞肺癌的临床观察

目的：对晚期非小细胞肺癌（non-small　cell　lung　cancer，NSCLC）应用吉非替尼后的疗效及毒副作用进行观察。方法：选择8例住院接受治疗的Ⅳ期非小细胞肺癌患者，且均为手术、放疗、化疗等治疗后失败的病例。治疗方案为Gefitinib单药口服250mg，1次／d，直至死亡或出现严重不良反应或病灶进展。全组服药的中位时间为8．6个月。结果：8例患者中4例部分缓解（PR），2例稳定（NC），2例进展（PD）；症状缓解6例，缓解最为明显的症状为憋气、咳嗽和疼痛，出现症状缓解的中位时间为14d。最常见的毒副作用为易于控制和逆转的皮疹和腹泻。结论：口服吉非替尼单药对于经手术、放疗、化疗失败的NSCLC是有效的且具有良好的耐受性。     

吉非替尼治疗晚期非小细胞肺癌疗效观察

目的:探讨吉非替尼单药治疗化疗失败的晚期非小细胞肺癌(NSCLC)的疗效及不良反应.方法:对化疗失败或不适宜化疗的晚期NSCLC患者25例,给予吉非替尼治疗.结果:25例中18例可评价疗效,有效率32.0%,疾病控制率68.0%.常见不良反应为Ⅰ、Ⅱ度皮肤改变和腹泻,Ⅲ度不良反应占7.6%.结论:初步研究结果提示,吉非替尼治疗女性,不吸烟,腺癌晚期NSCLC的疗效确切,不良反应小.适用人群证实肺腺癌后立即应用,观察2周若有效,可仅持续应用吉非替尼控制,无效者则选择综合治疗模式.     

吉非替尼治疗晚期非小细胞肺癌的临床研究

目的 探讨并观察表皮生长因子受体酪氨酸激酶抑制剂--吉非替尼(gefitinib, ZD1839,IRESSA)治疗晚期(Ⅲb、Ⅳ期)非小细胞肺癌(non-small cell lung cancer, NSCLC)的疗效和毒副反应.方法 观察2004年2月至2006年3月期间笔者所在科收集的32例晚期NSCLC患者接受吉非替尼(250 mg)顿服,直至病情进展或死亡或出现不可耐受的不良反应而终止治疗的情况.结果 32例晚期NSCLC患者,无1例完全缓解(CR),19例部分缓解(PR),9例稳定(SD),4例进展(PD);全组有效率(CR+PR)为59.38%,疾病稳定率28.13%,临床获益率(CR+PR+SD)为87.5%.缓解最为明显的症状主要为咳嗽咳痰减轻,胸闷气短好转及疼痛减轻.中位生存期3.5个月,截至随访时间,62.5%的患者仍存活.其疗效与性别和既往吸烟史有显著相关性,女性疗效优于男性,无吸烟史者优于有吸烟史者;最常见的药物不良反应主要表现为Ⅰ、Ⅱ度皮疹(25%, 9.38%)、腹泻(15.63%),不需特殊处理.结论 吉非替尼对于晚期NSCLC患者,尤其是对于亚裔女性、腺癌、未吸烟患者能较好地缓解疾病相关症状,毒副反应轻微,大多可耐受,是一种安全、有效并具有较好耐受性的治疗药物.     

吉非替尼治疗晚期非小细胞肺癌的临床研究

[目的]观察吉非替尼(Gefitinib)治疗含铂类化疗失败的晚期非小细胞肺癌的疗效及毒副作用.[方法]对76例含铂类化疗失败的晚期非小细胞肺癌患者给予吉非替尼250 mg/d口服治疗,持续服用直到疾病进展或出现不可耐受的毒副作用.[结果]76例患者中完全缓解(CR)3例(3.9%),部分缓解(PR)19例(25.0%),稳定(SD)30例(39.4%).总有效率(RR)为28.9%.临床获益率为68.3%(52/76).有效患者的中位缓解时间为8.3个月,中位肿瘤进展时间(TTP)为5.8个月,中位总生存期(OS)为12个月,1年生存率为47.6%.女性患者的有效率显著高于男性患者(P＜0.001).与药物相关的毒副作用依次为:皮疹29例(38.0%),腹泻16例(21.0%),皮肤干燥11例(14.43%),搔痒12例(15.7%).其他亦可出现恶心、ALT轻度升高等.[结论]吉非替尼可有效治疗含铂类化疗失败的晚期非小细胞肺癌.吉非替尼的毒副作用可耐受.     

Recurrence patterns of advanced non-small cell lung cancer treated with gefitinib

Background Gefitinib is widely used in the treatment of advanced non-small cell lung cancer (NSCLC).However,only a small number of reports have described initial failure sites in patients treated with ...     

Efficacy and safety of gefitinib as monotherapy for Chinese patients with advanced non-small cell lung cancer

PLATINUM-BASED CHEMOTHERAPY CAN IMPROVE THE SURVIVAL AND QUALITY OF LIFE OF PATIENTS WITH LOCALLY ADVANCED AND METASTATIC LUNG CANCER. SECOND-LINE DOCETAXEL MONOTHERAPY CAN IMPROVE OVERALL SURVIVAL FOLLOWING THE FAILURE OF FIRST LINE CHEMOTHERAPY. HOWEVER, MANY LIMITING FACTORS SUCH AS POOR PERFORMANCE STATUS, ADVANCED AGE, ADVERSE EFFECTS OF CHEMOTHERAPY AND RELUCTANCE …     

Manifestation of leukoencephalopathy in a patient with advanced non-small cell lung cancer following treatment with gefitinib

The present case is a patient with advanced non-small cell lung cancer (NSCLC) who developed leukoencephalopathy following radiotherapy and gefitinib treatments. There are rarely reports of such incidences because the median survival period of advanced NSCLC is only ten months. The features of leukoencephalopathy in this case were atypical for radiation leukoencephalopathy, so it was suspected that the leukoencephalopathy was associated with gefitinib.

     

Efficacy of gefitinib as a first-line single agent treatment in patients with advanced non-small cell lung cancer

Objective

To assess the efficacy and toxicity of gefitinib as a single agent treatment in Chinese patients with advanced non-small cell lung cancer (NSCLC).

Methods

Forty-five patients with advanced NSCLC were treated with gefitinib at 250 mg daily until the disease progressed or the patient could not tolerate the toxicity.

Results

None of the patients achieved a complete response (CR), while 15 patients achieved a partial remission (PR) and 17 experienced a stable disease (SD). Thirteen patients continued to have a progressive disease (PD). The response rate and the disease control rate were 33.3% and 71.1%, respectively. The symptom remission rate was 72.5%, and the median remission time was 8 days. The median survival time was 15.3 months. The median progression-free survival time was 6.0 months. The most common toxicities included rash (53.3%) and diarrhea (33.3%). Dehydration and pruritus of the skin developed in 26.7% and 22.2% of the patients, respectively. Hepatic toxicity occurred in 6.7% of patients and oral ulceration occurred in 4.4% of patients.

Conclusion

Single agent treatment with gefitinib is effective against advanced NSCLC, and is well tolerated in Chinese patients.     

Improvements in quality of life and disease-related symptoms in patients with advanced non-small cell lung cancer treated with gefitinib

Most patients with advanced non-small cell lung cancer （NSCLC） experienced mild to severe disease-related symptoms including fatigue, loss of appetite, chest pain, dyspnoea, cough and hemoptysis. These symptoms hamper the patients＇ ability to carry out daily activity and the deteriorating of disease-related symptoms is often associated with poor performance status, which may decrease the treatment options for patients. Furthermore,     

吉非替尼治疗58例晚期非小细胞肺癌的临床观察

目的:观察吉非替尼对晚期非小细胞肺癌的临床疗效及不良反应,以及对生活质量的影响。方法:选择2006年7月～2008年12月间ⅢB～Ⅳ期非小细胞肺癌患者58例,口服吉非替尼250 mg/次,每天一次,服药至病情进展或出现不能耐受的不良反应为止。结果:58例可评价非小细胞肺癌患者中,CR 1例(1.72%),PR 19例(32.76%),SD 24例(41.38%),PD 14例(24.14%),总有效率(RR)为34.48%,总的疾病控制率(DCR)为75.86%;腺癌的有效率高于鳞癌,女性的有效率高于男性,不吸烟者有效率高于吸烟者(P<0.05),接受过化疗和Ⅳ期患者有效率稍高,但无显著统计学差异(P>0.05)。中位生存时间11.3个月,1年生存率为43.6%,主要的不良反应中皮疹发生最多为39例(67.24%),腹泻14例(24.14%),肝功能轻度损害2例(3.45%)。结论:吉非替尼治疗晚期非小细胞肺癌疗效好,可以显著改善非小细胞肺癌患者的临床症状及生存质量,毒副反应较小,安全易耐受。     

112例老年晚期非小细胞肺癌病人一线应用EGFR-TKIs的疗效及安全性观察

目的：观察在晚期老年非小细胞肺癌患者中一线应用EGFR－TKIs靶向治疗药物的疗效及安全性。方法选取70岁以上晚期非小细胞肺癌患者共112例,应用吉非替尼（250 mg 1次／d口服）68例,应用厄洛替尼（150 mg 1次／d口服）15例,应用埃可替尼（125 mg 3次／d口服）29例。观察患者接受EGFR－TKIs治疗的疗效、不良反应及无进展生存期（ PFS）。结果112例患者接受EGFR－TKIs治疗,共109例完成治疗,本组无CR病例,26例患者获得PR,42例患者疗效为SD,41例患者PD,有效率（ORR）23．8％,疾病控制率（DCR）62．4％。3例不能耐受而中止用药。全组患者中位无进展生存期（ mPFS）为6．0个月。吉非替尼、厄洛替尼、埃可替尼各组间疗效无明显差异,P＞0．05。结论晚期老年非小细胞肺癌患者应用EGFR－TKIs靶向治疗药物安全有效,不良反应轻微,可耐受。吉非替尼、厄洛替尼、埃可替尼疗效无明显差异。     

Erlotinib as a salvage treatment for patients with advanced non-small cell lung cancer after failure of gefitinib treatment

Background  Several clinical trials showed that erlotinib was effective after the failure of gefitinib in advanced non-small cell lung cancer (NSCLC). The aim of this study was to evaluate the feasibility of erlotinib treatment after the failure of gefitinib based on the data from our hospital.

Methods  The clinical data of 20 patients with advanced NSCLC who were admitted to Shanghai Chest Hospital from August 2007 to December 2008 were retrospectively analyzed. All of the patients were given erlotinib treatment after the failure of gefitinib. Survival analysis was made by Kaplan-Meier method. The Cox regression model was performed to analyze the relationship between the influential factors and the erlotinib progression-free survival (PFS).

Results  Five patients had a partial response (PR), nine patients had stable disease (SD) and six patients had progressive disease (PD) with gefitinib treatment. The median PFS was 277 days (95% CI 0–566). No patient had a PR, seven had SD and fourteen PD with the erlotinib therapy. The median PFS was 31 days (95% CI 9.1–52.9). The response rate (RR) was 0, and the disease control rate (DCR) was 35% (7/20). Cox regression analysis demonstrated that sex (P=0.96), age (P=0.89), smoking history (P=0.78), performance status (PS) (P=0.98), gefitinib efficacy (P=0.90) and whether chemotherapy was applied between using the two drugs (P=0.45) had no significant correlation with erlotinib PFS. Fifteen patients had epidermal growth factor receptor (EGFR) mutation status determined. There were five cases got SD with the erlotinib treatment in ten mutation negative (wild-type) patients. No SD was recorded in the five mutation positive patients.

Conclusions  The efficacy of erlotinib treatment after gefitinib failure was limited. However, the patients who are EGFR mutation negative can probably benefit from erlotinib treatment after gefitinib failure.