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

目的　评价化疗后序贯给予厄洛替尼在晚期非小细胞肺癌（ＮＳＣＬＣ）中的客观缓解率和毒副反应。方法　初治或复治的局部晚期或晚期ＮＳＣＬＣ患者共３９例，初治患者２５例采用ＧＣ方案化疗，复治患者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（１５０ｍｇ／天，ｄ１５～ｄ２８），２８天为１周期。连用６周期，直至疾病进展或毒副反应不能耐受。结果　３９例患者至随访结束时共完成化疗１３５个周期，平均化疗３４６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１４例），ＰＤ７例（初治２例）。总体客观缓解率（ＲＲ）为２３１％，其中初治ＲＲ为２８.０％（７／２５），复治ＲＲ１４.３％（２／１４），总体疾病控制率（ＤＣＲ）为８２.１％，初治患者为９２.０％，复治患者６４.３％。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。

Sequential erlotinib in combination with chemotherapy in the treatment of advanced non-small cell lung cancer

Objective This study investigated whether sequential administration of erlotinib and chemotherapy improved objective response rate and side effects in patients with advanced non-small cell lung cancer（NSCLC）. Methods Previously treated or untreated patients（ n = 39） with stage Ⅲ B/Ⅳ NSCLC were received either erlotinib（150mg/day） on days 15-28 of a 4-week cycle that included gemcitabine in the initial patients and doeocetaxel or pemetrexed in the retreated patients, either as well as cisplatin or carboplatin. The primary endpoint was tumor response rate and safety. Results Thirty-nine advanced NSCLC patients was retrospectively reviewed. Among 39 patients ,25 was treated as the first-line therapy, 14 was second or third-line. One hundred and thirty-five cycles were finished, the average cycle was 3.46. In 39 patients no complete regression was observed, 9 had partial response （ PR）, and 23 stable disease（SD） ,while 7 had progress of disease（PD）. The overall disease control（ PR ＋ SD） was 82. 1%, the total response rate was 23.1%. Most of the side effects were rash and hematologic toxicity. Conclusion Sequential administration of erlotinib and chemotherapy in NSCLC is effective in a short time,the toxicity can be well tolerated. The long effect should be observed.