摘要
目的： 探讨厄洛替尼与紫杉醇联合卡铂化疗治疗表皮生长因子受体（EGFR）突变的老年非小细胞肺癌（NSCLC）患者的临床疗效和安全性。方法：选取2011年1月-2012年6月住院治疗的老年NSCLC患者共90例,按照2：1的病例随机化分为2组。厄洛替尼组60例,150 mg/次,qd,服用直至出现严重不良反应;对照组30例,紫杉醇175 mg/m2静滴,d1,卡铂按AUC5计算药量,静滴,每21天为1周期,共4周期后定期复查。结果：厄洛替尼组有效率和疾病控制率分别为81.0%（47/58）和89.7%（52/58）,明显高于对照组34.5%（10/29）和62.1%（18/29）,差异均有统计学意义（P〈0.05）。厄洛替尼组中位无进展生存期为12.1个月（95%CI：10.32～13.01个月）,明显高于对照组 6.2个月（95% CI： 3.18～8.01个月）,差异有统计学意义（P 〈0.05）;但两组中位生存期分别为 19.3个月（95%CI：16.51～22.31个月）和17.2个月（95%CI：14.56～18.64个月）,差异无统计显著性（P〉0.05）。2组药物不良发应多为 1和 2级,未出现不能耐受者或者药物相关死亡病例。对照组发生 CTC 3～4级发生率为60.0%（18/30）明显高于厄洛替尼组 11.7%（7/60）,差异有统计学意义（χ2=23.289, P =0.000）。结论：厄洛替尼能提高EGFR突变老年 NSCLC患者的治疗有效率、疾病控制率,中位无进展生存期明显较长,不良反应发生率低、症状轻,可以考虑作为EGFR突变老年NSCLC患者治疗的替代药物。
OBJECTIVE To explore the efficacy and adverse effects of erlotinib and paclitaxel-carboplatin for the treatment of elderly patients with non-small cell lung cancer （NSCLC） and epidermal growth factor receptor （EGFR） mutation. METHODS 90 elderly patients with NSCLC and EGFR mutation were admitted from Jan. 2011 to Jun. 2012 in our hospital, and randomly divided into two groups according the ratio of 2： 1. Erlotinih group （60 patients, 150 mg·d-1 , taking continuously until seriously adverse effects or disease progress） and control group （30 patients , paclitaxel 175 mg·m-2, carboplatin AUC 5, once per 21 days, regular reexamination after 4 weeks）. RFNULTS The rates of efficiency and disease control in erlotinib group were 81.0 % （47/58） and 89.7 % （52/58）, significantly higher than those [34.5 % （ 10/29）, 62.1% （18/29） ] in control group. The differences were statistically significant （P〈0. 05）. The median progression-free survival in erlotinib group was 12.1 months （95% CI： 10.32 - 13.01 months）, significantly higher than that [6.2 months （95% CI： 3.18 - 8.01 months）] in control group. The difference was statistically significant （P〈0.05）; but the median survival time in both groups were 19.3 months （95% CI： 16.51 - 22.31 months） and 17.2 months （95% CI： 14.56 - 18.64 months ） . The difference was not statistically significant （P〈0.05）. The mainly adverse effects in both groups were grade one or two and no tolerance occurred or drug-related death. The rate of CTC grade 3 - 4 adverse effects in control group was 60.0% （18/30）, significantly higher than that [-11.7% （7/60）] in erlotinib group. The difference was statistically significant （χ2 = 23. 289, P = 0. 000）. CONCLUSION Erlotinib treatment can elevate RR, DCR, and PFS in elderly patients with NSCLC and EGFR mutation. Its adverse reactions were few and mild. Erlotinib may be considered as an alternative medicine in elderly patients with NSCLC and EGFR mutation.
出处
《中国医院药学杂志》
CAS
CSCD
北大核心
2014年第13期1108-1112,共5页
Chinese Journal of Hospital Pharmacy
基金
河南省基础与前沿资助项目(编号:122300410068)
关键词
非小细胞肺癌
表皮生长因子受体
厄洛替尼
紫杉醇
卡铂
non-small cell lung cancer
epidermal growth factor receptor
erlotinib
paclitaxel
carboplatin
