上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (3): 305-.doi: 10.3969/j.issn.1674-8115.2011.03.013

• 论著（临床研究） • 上一篇    下一篇

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

顾爱琴, 高志强, 王慧敏, 施春雷, 熊丽纹, 韩宝惠   

  1. 上海交通大学附属胸科医院肺内科, 上海 200030
  • 出版日期:2011-03-28 发布日期:2011-03-29
  • 通讯作者: 韩宝惠, 电子信箱: xkyyhan@yahoo.cn。
  • 作者简介:顾爱琴（1964—）, 女, 主任医师, 硕士；电子信箱: guaiqin11@126.com。

Clinical analysis of gefitinib in treatment of elderly patients with advanced non-small cell lung cancer

GU Ai-qin, GAO Zhi-qiang, WANG Hui-min, SHI Chun-lei, XIONG Li-wen, HAN Bao-hui   

  1. Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai 200030, China
  • Online:2011-03-28 Published:2011-03-29

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摘要：

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。

关键词: 非小细胞肺癌, 老年患者, 吉非替尼, 靶向治疗

Abstract:

Objective To evaluate the efficacy and safety of gefitinib in the treatment of elderly patients with advanced non-small cell lung cancer (NSCLC). Methods Eighty-seven patients with NSCLC (stage ⅢB to stage Ⅳ) were treated with gefitinib (250 mg/d) until disease progression or development of intolerable toxicity. Results The overall response rate and disease control rate were 31.0％(27/87) and 77.0％(67/87), respectively. The median progression-free survival time and median survival time was 6.6 months and 12.3 months, respectively. One year survival rate was 52.9%. The response rate and disease control rate of those with adenocarcinoma and no history of chemotherapy were significantly higher than those with non-adenocarcinoma and history of chemotherapy (P<0.05). The disease control rates of females and non-smokers were significantly higher than those of males and smokers (P≤0.01). The median progression-free survival time of those with ECOG performance status scale score of 0-1, adenocarcinoma, no smoking and response to gefitinib treatment was significantly longer than that of those with ECOG performance status scale score ≥2, non-adenocarcinoma, smoking and no response to gefitinib treatment (P<0.01). The median survival time of those with ECOG performance status scale score of 0-1 and response to gefitinib treatment was significantly longer than those with ECOG performance status scale score ≥ 2 and no response to gefitinib treatment (P≤0.001). The most common adverse effects were rash (56.3%) and diarrhea (36.8%). Conclusion Treatment with gefitinib is effective and tolerable for elderly patients with advanced NSCLC.

Key words: non-small cell lung cancer, elder, gefitinib, targeted therapy