作者单位： 523029 东莞，东莞市人民医院肿瘤内科

    化学治疗交替吉非替尼治疗EGFR突变阳性的晚期非小细胞肺癌的疗效和安全性

    江冠铭贾筠陈镜塘吴依芬谭钦全卢志斌

    【摘要】目的探讨化学治疗交替吉非替尼一线治疗表皮生长因子受体(EGFR)突变阳性的晚期非小细胞肺癌的临床疗效及安全性。方法选取40例初诊的EGFR突变阳性的非小细胞肺癌晚期患者，分别于疗程的第1、8日予吉西他滨1 000 mg/m2、第1日予顺铂75 mg/m2或卡铂AUC 5、第15～28日予吉非替尼250 mg/d，每28 d为1个周期，根据患者病情行4～6个周期的化学治疗，然后患者继续口服吉非替尼250 mg/d至疾病进展或出现难以耐受的不良反应。观察治疗效果及毒副反应。结果入组的40例患者中位无进展生存期为17(10～29)个月，中位总生存期为30(22～41)个月；客观缓解率为85%(0例完全缓解，34例部分缓解)。不良反应大多属于Ⅰ～Ⅱ度，以贫血、中性粒细胞减少、恶心、呕吐及皮疹为主。 结论化学治疗交替吉非替尼治疗EGFR突变阳性晚期非小细胞肺癌的疾病缓解率较高，且不良反应程度较轻。

    【关键词】晚期非小细胞肺癌；EGFR突变阳性；吉西他滨；顺铂；卡铂；吉非替尼

    DOI：10.3969/g.issn.0253-9802.2015.06.011

    通讯作者，贾筠，E-mail: dgryjy@sina.com

    收稿日期：(2015-02-27)

    Efficacy and safety of alternate chemotherapy with gefitinib in treatment of advanced non-small cell lung cancer with positive mutation of EGFRJiangGuanming，JiaYun，ChenJingtang，WuYifen，TanQinquan，LuZhibin.DepartmentofMedicalOncology，DongguanPeople’sHospital，Dongguan523029,China

    Correspondingauthor，JiaYun，E-mail:dgryjy@sina.com

    Abstract【】ObjectiveTo evaluate the clinical efficacy and safety of alternate chemotherapy with first-line gefitinib in treating advanced non-small cell lung cancer with positive mutation of epidermal growth factor receptor (EGFR). MethodsForty patients first diagnosed with advanced non-small cell lung cancer with positive EGFR mutation were enrolled. They were scheduled to receive gemcitabine at a dose of 1000 mg/m2 on days 1 and 8, cisplatin 75 mg/m2 or carboplatin AUC 5 on day 1 and gefitinib 250 mg/day from days 15 to 28. One cycle of therapy endured for 28 days. After 4～6 cycles of chemotherapy based upon individual situation, gefitinib was administered orally at a dose of 250 mg/day until disease progression or intolerable toxicity occurred. Clinical efficacy and toxicity were observed. ResultsThe median progression-free survival (PFS) of the 40 patients was 17 months (range 10-29 months) and the median overall survival (OS) was 30 months (range 22-41 months). The objective response rate was 85% (no case with complete remission and 34 with partial remission). A majority of toxicities were grade I-II, mainly including anemia, neutropenia, nausea, vomiting and rash. ConclusionAlternate chemotherapy with first-line gefitinib yielded high remission rate and mild toxic responses in treating advanced non-small cell lung cancer with positive mutation of EGFR. ......