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吉非替尼联合顺铂和吉西他滨治疗晚期非小细胞肺癌的疗效及生存相关因素

Efficacy and survival-associated factors with gefitinib combined with cisplatin and gemcitabine for advanced non- small cell lung cancer.

作者信息

Fang Hong, Lin Rong-Yan, Sun Ming-Xia, Wang Qian, Zhao Yu-Liang, Yu Jing-Lin, Tian Yan, Wang Xiao-Yun

机构信息

Department of Oncological Chemotherapy, Peking University First Hospital, Beijing, China E-mail :

出版信息

Asian Pac J Cancer Prev. 2014;15(24):10967-70. doi: 10.7314/apjcp.2014.15.24.10967.

Abstract

OBJECTIVE

To analyze the efficacy and survival associated factors of gefitinib combined with cisplatin and gemcitabine for advanced non-small cell lung cancer.

MATERIALS AND METHODS

A total of 57 patients with advanced non-small cell lung cancer (NSCLC), who received platinum-based chemotherapy regimens for more than 1 cycle, were treated with gefitinib combined with cisplatin and gemcitabine until disease progression. Efficacy, survival time and adverse reactions were observed. The Kaplan-Meier method was adopted for analysis of survival and Cox regression for associated influencing factors.

RESULTS

The patients were followed up until October 31, 2013, and the median follow-up time was 19 months. Of 57 patients, there were 4 (7.0%) with complete remission (CR), 8 (14.0%) with partial remission, 31 (54.4%) with stable disease, and 14 (24.6%) with disease progression. The remission rate was 21.1% and the disease control rate was 75.4%. The median progression-free survival (PFS) time and the median overall survival time were 10 months and 15.2 months. The one-year, two-year and three- year survival rates were 47.4%, 23.3% and 10.0%. Gender and pathological types were the independent risk factors influencing PFS time (P=0.028, P=0.009). Tumor pathological type and early efficacy were independent factors for the prognosis (P=0.018, P=0.000). Adverse reactions were mostly rashes of I~II degree and diarrhea and slightly increasing level of aminopherase. The skin adverse event incidence of III degree or above was 1.8% (1/57) and brain metastasis was foudn in 31.6% (18/57).

CONCLUSIONS

Gefitinib combined with cisplatin andgemcitabine, is effective for patients with IIIb~IV NSCLC who received multiple cycles of chemotherapy.

摘要

目的

分析吉非替尼联合顺铂和吉西他滨治疗晚期非小细胞肺癌的疗效及生存相关因素。

材料与方法

选取57例接受过1个以上周期铂类化疗方案的晚期非小细胞肺癌(NSCLC)患者,采用吉非替尼联合顺铂和吉西他滨治疗,直至疾病进展。观察疗效、生存时间及不良反应。采用Kaplan-Meier法分析生存情况,采用Cox回归分析相关影响因素。

结果

患者随访至2013年10月31日,中位随访时间为19个月。57例患者中,完全缓解(CR)4例(7.0%),部分缓解8例(14.0%),病情稳定31例(54.4%),病情进展14例(24.6%)。缓解率为21.1%,疾病控制率为75.4%。中位无进展生存期(PFS)时间和中位总生存期分别为10个月和15.2个月。1年、2年和3年生存率分别为47.4%、23.3%和10.0%。性别和病理类型是影响PFS时间的独立危险因素(P=0.028,P=0.009)。肿瘤病理类型和早期疗效是影响预后的独立因素(P=0.018,P=0.000)。不良反应主要为Ⅰ~Ⅱ度皮疹、腹泻及转氨酶水平轻度升高。Ⅲ度及以上皮肤不良事件发生率为1.8%(1/57),脑转移发生率为31.6%(18/57)。

结论

吉非替尼联合顺铂和吉西他滨对接受多周期化疗的Ⅲb~Ⅳ期NSCLC患者有效。

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