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表皮生长因子受体酪氨酸激酶抑制剂作为晚期非小细胞肺癌患者一线治疗的应用

[Application of epidermal growth factor receptor tyrosine kinase inhibitor as the first-line therapy in patients with advanced non-small cell lung cancer].

作者信息

Xu Yang, Chen Liangan, Tian Qing, Yang Zhen, Zhao Wei, Wang Ping, Liu Xingchen, Li Chunsun

机构信息

Department of Respiratory Medicine, Chinese PLA General Hospital, Beijing 100853, China.

出版信息

Zhongguo Fei Ai Za Zhi. 2010 Jan;13(1):48-53. doi: 10.3779/j.issn.1009-3419.2010.01.09.

Abstract

BACKGROUND AND OBJECTIVE

Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) has been widely used as the second- and third-line therapy in patients with advanced non-small cell lung cancer (NSCLC). However, its effect in the first-line treatment is unclear. The aim of this study was to evaluate the efficacy and safety of EGFR-TKI as first-line therapy.

METHODS

The clinical characteristics, responses rate, disease control rate and overall survival were retrospectively analyzed in 77 chemonaive patients with advanced NSCLC. All of the patients received oral gefitinib (250 mg/d) or erlotinib (150 mg/d) until disease progression or unacceptable toxicity occurrence.

RESULTS

The overall response rate was 33.8% and the disease control rate was 68.8%. The median progression-free survival and the median survival time were 6.0 months and 8.9 months, respectively. One-year survival rate was 61.4%. Responses correlated significantly with histology, PS score, smoking history, skin rash, EGFR mutations and serum CEA. Histology and skin rash were the independent predictors of survival. Common toxicities were skin rash and mild diarrhea. EGFR-TKI could improve the clinical symptoms and the quality of life.

CONCLUSION

EGFR-TKI is effective and well tolerated as first-line therapy in patients with advanced NSCLC.

摘要

背景与目的

表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)已被广泛用作晚期非小细胞肺癌(NSCLC)患者的二线和三线治疗。然而,其一线治疗效果尚不清楚。本研究旨在评估EGFR-TKI作为一线治疗的疗效和安全性。

方法

回顾性分析77例初治晚期NSCLC患者的临床特征、缓解率、疾病控制率和总生存期。所有患者均接受口服吉非替尼(250mg/d)或厄洛替尼(150mg/d)治疗,直至疾病进展或出现不可接受的毒性反应。

结果

总缓解率为33.8%,疾病控制率为68.8%。无进展生存期和总生存期的中位数分别为6.0个月和8.9个月。1年生存率为61.4%。缓解与组织学类型、PS评分、吸烟史、皮疹、EGFR突变和血清CEA显著相关。组织学类型和皮疹是生存的独立预测因素。常见毒性反应为皮疹和轻度腹泻。EGFR-TKI可改善临床症状和生活质量。

结论

EGFR-TKI作为晚期NSCLC患者的一线治疗有效且耐受性良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bd8/6000684/9629c257e33a/zgfazz-13-1-48-1.jpg

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