目的：观察吉非替尼对老年非小细胞肺癌化学治疗（简称化疗）后脑转移疗效、不良反应及疾病控制率的影响。方法选取医院2012年9月至2014年9月收治的老年非小细胞肺癌化疗后脑转移患者80例，随机分为吉非替尼组和吉西他滨组，各40例。统计并分析两组患者的临床疗效、不良反应、生活质量、无进展生存期（PFS）及总生存期（OS）。结果吉非替尼组患者的总有效率、疾病控制率（DCR）分别为35．00％和80．00％，均显著高于吉西他滨组的22．50％和60．00％（ P﹤0．05）；1~2级骨髓抑制、恶心呕吐发生率均显著低于吉西他滨组（ P﹤0．05）；痤疮样皮疹发生率、躯体功能评分及总分均显著高于吉西他滨组（ P﹤0．05）；PFS及OS均显著长于吉西他滨组（ P﹤0．05）。结论吉非替尼较吉西他滨更能有效提高老年非小细胞肺癌化疗后脑转移的临床疗效，并能减少患者的不良反应，值得临床推广。%Objective To investigate the influences of gefitinib in efficacy,adverse reactions and disease control rate of elderly patients with non-small cell lung cancer brain metastasis after chemotherapy. Methods 80 cases of elderly patients with non-small cell lung cancer brain metastasis after chemotherapy in the hospital from September 2012 to September 2014 were selected and randomly divided into the gefitinib group( n=40)and gemcitabine group( n=40);the clinical efficacy,adverse reactions,life quality,PFS and OS of the two groups were statistically analyzed. Results The RR,DCR of the gefitinib group 35. 00%,80. 00% were significantly higher than the gemcitabine group 22. 50%,60. 00%( P ﹤ 0. 05);the incidences of grade 1-2 myelosuppression,nausea and vomiting were significantly lower( P ﹤ 0. 05),the acne like rash was significantly higher( P ﹤ 0. 05),the physical function score and total score were significant-ly higher( P ﹤ 0. 05),the PFS and OS were significantly longer than the gemcitabine group. Conclusion Gefitinib is more effective in improving the clinical efficacy,reduce the toxic side effects of elderly patients with non-small cell lung cancer brain metastasis after chemotherapy than gemcitabine.
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