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吉非替尼治疗非小细胞肺癌患者时引起的肝毒性。

Gefitinib-induced hepatotoxicity in patients treated for non-small cell lung cancer.

作者信息

Chen Jing, Gu Runxia, Wang Qiong, Dassarath Meera, Yin Zhongyuan, Yang Kunyu, Wu Gang

机构信息

Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Onkologie. 2012;35(9):509-13. doi: 10.1159/000341828. Epub 2012 Aug 13.

Abstract

BACKGROUND

Although epidermal growth factor receptor (EGFR)-specific tyrosine kinase inhibitors (TKIs) are widely used in the management of advanced non-small cell lung cancer (NSCLC), gefitinib-induced hepatotoxicity has been underappreciated and rarely reported.

CASE REPORT

The medical records of 92 NSCLC patients, who were admitted to our cancer center in the past 5 years, were reviewed retrospectively. All patients received treatment with gefitinib (250 mg/day), during which liver function was monitored. Of the 92 NSCLC patients, 6 (6.5%) developed mild to moderate hepatotoxicity during gefitinib treatment. The time of onset of hepatotoxicity ranged from 7 days to 6 months after gefitinib administration. 1 patient (1.1%) suffered from grade 2 hepatotoxicity, and gradually recovered her normal liver function after reduction of the gefitinib dose. The other 5 patients with grade 1 hepatic impairment tolerated gefitinib well without requiring dose reductions or drug cessation.

CONCLUSION

Gefitinib-induced hepatotoxicity is not uncommon. Although the extent of this toxicity is generally mild in nature and most patients tolerate gefitinib well, meticulous monitoring is mandatory to avoid severe hepatic impairment.

摘要

背景

尽管表皮生长因子受体(EGFR)特异性酪氨酸激酶抑制剂(TKIs)广泛应用于晚期非小细胞肺癌(NSCLC)的治疗,但吉非替尼诱导的肝毒性一直未得到充分认识且报道较少。

病例报告

回顾性分析了过去5年我院癌症中心收治的92例NSCLC患者的病历。所有患者均接受吉非替尼(250 mg/天)治疗,治疗期间监测肝功能。92例NSCLC患者中,6例(6.5%)在吉非替尼治疗期间出现轻至中度肝毒性。肝毒性的发病时间在吉非替尼给药后7天至6个月之间。1例患者(1.1%)出现2级肝毒性,在减少吉非替尼剂量后肝功能逐渐恢复正常。其他5例1级肝功能损害患者对吉非替尼耐受性良好,无需减量或停药。

结论

吉非替尼诱导的肝毒性并不少见。虽然这种毒性的程度一般较轻,大多数患者对吉非替尼耐受性良好,但必须进行细致监测以避免严重肝功能损害。

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