吉非替尼治疗晚期肺腺癌疗效的相关因素分析(1)
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【摘要】 目的 旨在分析吉非替尼治疗晚期肺腺癌疗效的预测因素。方法 对2005年12月至2007年12月期间在广州医学院第一附属医院接受吉非替尼单药治疗且进行了EGFR基因突变检测的29例局部晚期或转移性肺腺癌患者的临床、病理特征与吉非替尼治疗疗效的相关情况进行了回顾性分析。结果 29例患者客观缓解率为51.7%，疾病控制率为82.8%，中位疾病进展时间3.2个月；EGFR基因突变阳性患者的客观缓解率、疾病控制率和疾病无进展时间均显著优于EGFR基因野生型患者；不吸烟患者的客观缓解率和疾病无进展时间均显著优于吸烟者；性别、临床分期状况与吉非替尼治疗疗效无明显相关。结论 吉非替尼治疗晚期复治性肺腺癌疗效显著，不良反应轻微；EGFR基因突变阳性和不吸烟是预测吉非替尼治疗肺腺癌疗效的有益标志。
【关键词】 肺腺癌;吉非替尼/治疗应用;预测因素
Predictors of efficacy of Gefitinib in local advanced or metastatic patients with lung adenocarcinoma
HE Chen, LIU Ming, ZHOU Cheng-zhi, et al. Department of Respiratory, Baoan Peoples Hospital, Shenzhen,518101,China
【Abstract】 Objective To identify the predictors of efficacy of Gefitinib in local advanced or metastatic patients with lung adenocarcinoma. Methods The relationship between the clinical and pathological features and efficacy of gefitinib were analyzed retrospectively in 29 local advanced or metastatic patients with lung adenocarcinoma in the First Affiliated Hospital of Guangzhou Medical College from December 2005 to December 2007. Results The objective response rate was 51.7%, disease control rate was 82.8%, and the median time to progression was 3.2 months.The objective response rate, disease control rate and disease progression-free time was significantly better in patients with EGFR mutation than that in patients with wild-type EGFR gene,the objective response rate and disease progression-free time was also significantly better in non-smokers than that in smokers. However,there was no significant relationship between the status of gender, clinical stage and efficacy of Gefitinib. Conclusion Gefitinib is effective in local advanced or metastatic lung patients with mild adverse reactions, and EGFR mutation and smoking status are useful predictors of efficacy of Gefitinib in local advanced or metastatic patients with lung adenocarcinoma.
【Key words】 Lung adenocarcinoma;Gefitinib; Predictive factors
肺癌是临床最常见的恶性肿瘤之一，其发病率和死亡率增长迅速，为我国城市肿瘤相关死亡的主要病因，严重危害人类健康和生命，其中80%为非小细胞肺癌(non-small cell lung cancer，NSCLC)，主要包括鳞癌、腺癌和大细胞肺癌三种病理类型。大多数NSCLC患者确诊时已经是中晚期，失去手术根治机会，传统的以含铂类和紫杉类药物化疗为主的综合治疗疗效较差、毒副作用大；以吉非替尼为代表的表皮生长因子受体(epidermal growth factor receptor ......
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