背景与目的 吉非替尼(商品名易瑞沙)是表皮生长因子受体酪氨酸激酶抑制剂,现广泛应用于晚期非小细胞肺癌.易瑞沙对于女性、腺癌、非吸烟者、亚洲人的疗效较好.已有一些临床研究发现使用易瑞沙临床获益的患者疾病进展后,再次使用易瑞沙可能会获益.本研究旨在评估二次使用易瑞沙的疗效及安全性.方法 回顾性分析我院18例初始使用易瑞沙临床获益的晚期肺腺癌患者治疗失败后二次使用易瑞沙治疗的疗效.结果 二次易瑞沙治疗后,1例患者获得部分缓解,11例患者获得疾病稳定,6例患者疾病进展.疾病控制率为67％,中位无进展生存为5.16个月.初次使用易瑞沙的中位生存时间为39.4个月,二次使用易瑞沙的中位生存时间为12.41个月.不良反应可以耐受.结论 初次使用易瑞沙有效的晚期肺腺癌患者,二次使用易瑞沙仍有可能延长患者的生存时间.%Background and objective Gefitinib is an epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) that has been widely used for the treatment of non-small cell lung cancer (NSCLC). It is most effective in women, as well as in patients who have never smoked, have pulmonary adenocarcinomas, or are of Asian origin. Several treatment options are available for NSCLC patients who responded to initial gefitinib therapy but demonstrated tumor progression, of which gefitinib readministration is the chosen therapeutic option. Ihe present study aims to evaluate the efficacy and toxicity of gefitinib readministration. Methods Ihe clinical data of 18 patients with NSCLC who had shown partial response (PR) or achieved a stable disease (SD) status after gefitinib administration and were retreated with gefitinib due to failure of the initial therapy were reviewed and retrospectively analyzed. Results Of the 18 patients studied, 1 (6%) showed partial remission (PR), 11 (61%) achieved SD, and 6 (33%) experienced disease progression. The disease control rate was 67%, and the median progression-free survival was 5.16 months (range, 1 to 24.8 months). The median overall survival from the start of the gefitinib therapy was 39.4 months (range, 15.38 to 52.44 months). Moreover, the median overall survival from the beginning of the 2nd therapy was 12.41 months (range, 3.98 to 38.24 months). Mild toxicity was observed with the 2nd gefitinib therapy. Conclusion The results of the present study indicate that patients with NSCLC may still be expected to achieve prolonged survival through gefitinib readministration if they initially responded to gefitinib and underwent various subsequent treatments.
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