易瑞沙治疗男性、不吸烟或轻度吸烟的晚期肺腺癌患者疗效研究

目的探讨易瑞沙单药治疗男性、不吸烟或轻度吸烟的晚期肺腺癌患者疗效与不良反应。方法 2006年10月—2009年12月共25例男性、不吸烟或轻度吸烟的晚期肺腺癌患者接受易瑞沙250mg/d口服治疗,观察患者的疗效、TTP、MST和不良反应。结果本组25例患者均可评价疗效,其中完全缓解2例,部分缓解10例,稳定9例,进展4例。有效率为48%,疾病控制率为84%,中位TTP为285天,1年无进展生存率为32%,MST为446天,1年生存率为36%。最常见不良反应主要为皮疹和腹泻。有效率与患者性别、年龄、一般状况、分期及既往治疗无关。TTP与患者年龄及PS评分无关;与TTP相关的因素包括分期、既往治疗、腹泻。IV期较IIIB期患者进展风险高（HR=16.042,P=0.028）,有放疗史的患者进展风险高（HR=5.176,P=0.018）,有手术史的患者进展风险低（HR=0.091,P=0.024）。出现腹泻的患者疾病进展风险相对较小（HR=0.246,P=0.246）。结论易瑞沙治疗河南本地腺癌、不吸烟的晚期NSCLC的疗效显著,总体生存明显获益,不良反应轻微。

Gefitinib Therapy of Never Smoked or Light Smoked Male Advanced Lung Adenocarcinoma

Objective The aim of this study is to evaluate the efficacy and toxicity of gefitinib in the treatment of never smoked or light smoked male advanced lung adenocarcinoma.Methods From Oct 2006 to Dec 2009,25 never smoked or light smoked male advanced lung adenocarcinoma patients had received gefitinib 250mg/d until disease progressing or intolerable toxicity developing.We reviewed the efficacy,time to progression,median survival time,and toxicity.Results All 25 patients could be evaluated.2 cases got complete response,10 cases got partial response,9 cases had no change and 4 had disease progression.So the response rate was 48%,and the clinical benefit rate was 84%.Median time to progression and median overall survival period were 285 and 446 days,respectively.One year progression-free survival rate and 1-year overall survival rate were 32% and 36%,respectively.The common adverse effects were skin rash and diarrhea.There was no correlation between the response rate and age、PS、treatment history 、TNM stage、rash and diarrhea.There was no correlation between TTP and age and PS.TTP is related to TNM stage、operation and radiotherapy history、diarrhea.The disease progression risk is higher in the patients who have stage IV disease（HR=16.042,P=0.028） and who ever received radiotherapy（HR=5.176,P=0.018）,lower in the patients who ever received operation（HR=0.091,P=0.024） and who have diarrhea（HR=0.246,P=0.246）.Conclusion Gefitinib is effective in treatment of never smoked or light smoked male advanced lung adenocarcinoma（from Henan Province）,OS is significantly prolonged and the adverse effects are tolerable.