吉非替尼治疗31例晚期非小细胞肺癌的临床观察

【目的】探讨吉非替尼治疗晚期非小细胞肺癌（NSCLC）的疗效和毒副反应。【方法】选择晚期不能耐受化疗及不愿接受化疗的晚期NSCLC患者31例用吉非替尼治疗，直到病变进展或出现不可耐受的毒副反应而终止，观察其疗效和毒副反应。【结果】31例晚期NSCLC中，吉非替尼的有效率为38．7％，疾病控制率为61．3％，症状缓解率为38．7％，中位无进展生存期为4．5个月，中位生存期为10．5个月，1年生存率为35．3％。服药28d后卡氏（KPS）评分提高（18±5）分，主要的毒副反应为皮疹、皮肤瘙痒、腹泻和恶心呕吐，最常见的是皮疹和腹泻，多为Ⅰ～Ⅱ度，对症处理后可缓解，未出现Ⅲ～Ⅳ度药物毒性反应。【结论】吉非替尼对于治疗不愿或不能接受传统细胞毒性药物化疗的晚期NSCLC疗效确切，可以显著改善临床症状和生活质量，毒副反应轻，且耐受性好。

Clinical Observation of Gefitinib in the Treatment of 31 Patients with Advanced Non-small Cell Lung Cancer

Objective] To explore the efficacy and toxicities of gefitinib in the treatment of patients with advanced non-small cell lung cancer（NSCLC）. Methods] Thirty one patients with advanced NSCLC who had not tolerated or refused chemotherapy received gefitinib until the disease progression or intolerable toxicities. The effect and toxieities were observed. Results]Of the 31 advanced patients,the response rate was 38.7%. The disease control rate was 61.3%. The rate of symptom relief was 38. 7%. The median progression-free survival was 4.5 months. The median survival time was 10.5 months. One-year survival rate was 35.3%. Af- ter taking medicine for 28 days, KPS score increased 18± 5 points. The main toxieities were rash, itch of skin, diarrhea, nausea and vomiting. The most common drug-related adverse events were rash and diarrhea mainly with Ⅰ- Ⅱ degree, which could be relieved after the treatment of the symptoms. No drug-related ad- verse reaction occurred. Conclusion] Gefitinib is effective in the treatment of patients with advanced NSCLC who are unwilling or unable to be treated by chemotherapy. It can significantly improve the clinical symptoms and quality of life with less toxicity and good tolerance.