Furukawa Kinya, Ishida Junzo, Inagaki Masaharu, Takabe Kazuhiko, Ishikawa Shigemi, Sakai Mitsuaki, Ichimura Hideo, Kamiyama Koichi, Kaburagi Takayuki, Hayashihara Kenji, Kishi Koji, Saito Makoto, Satoh Hiroaki
Tokyo Medical University, Ibaraki Medical Center;
Exp Ther Med. 2012 Jan;3(1):53-59. doi: 10.3892/etm.2011.360. Epub 2011 Oct 7.
There is no standard treatment and there are no clearly defined guidelines for the treatment of postoperative recurrent non-small-cell lung cancer (NSCLC). We performed a retrospective population-based study to assess the benefits of treatment with gefitinib in patients with a postoperative recurrence of NSCLC in general clinical practice. This retrospective population-based study was conducted on patients with postoperative recurrent NSCLC who had been treated with gefitinib at 14 institutions in Ibaraki Prefecture between July 2002 and September 2007. The objective response rate to gefitinib therapy was 37.6% for local and distant recurrence. The median survival time following the start of gefitinib therapy was 12 months, and the one-year and two-year survival rates were 48.9 and 28.9%, respectively. The median survival time of the females was 19 months, and the median survival time of the males was 9 months (p=0.002). Univariate analysis showed that female gender, adenocarcinoma, a performance status (PS) of 0-1 and absence of smoking history were favorable prognostic factors. Only female gender and a PS of 0-1 were independent statistically significant prognostic factors in the multivariate analysis. The rate of greater than grade 1 interstitial lung damage as an adverse event was 3.5%. Gefitinib is a feasible treatment for postoperative recurrent NSCLC in general clinical practice, and a good response and prolonged survival were obtained, similar to the findings reported in published clinical studies that were conducted on highly selected patients.
对于术后复发性非小细胞肺癌（NSCLC），目前尚无标准治疗方法，也没有明确界定的治疗指南。我们开展了一项基于人群的回顾性研究，以评估在一般临床实践中，吉非替尼治疗术后复发性NSCLC患者的疗效。这项基于人群的回顾性研究纳入了2002年7月至2007年9月期间在茨城县14家机构接受吉非替尼治疗的术后复发性NSCLC患者。吉非替尼治疗局部和远处复发的客观缓解率为37.6%。开始吉非替尼治疗后的中位生存时间为12个月，1年和2年生存率分别为48.9%和28.9%。女性的中位生存时间为19个月，男性为9个月（p = 0.002）。单因素分析显示，女性、腺癌、体能状态（PS）为0 - 1以及无吸烟史是有利的预后因素。多因素分析中，只有女性和PS为0 - 1是具有统计学意义的独立预后因素。作为不良事件的大于1级间质性肺损伤发生率为3.5%。在一般临床实践中，吉非替尼是治疗术后复发性NSCLC的一种可行治疗方法，且获得了良好的反应和延长的生存期，这与在高度选择的患者中进行的已发表临床研究报告的结果相似。
