王 礼,吴月兵,余伟江.酪氨酸激酶抑制剂与化疗交替联合治疗晚期肺腺癌的临床疗效[J].肿瘤学杂志,2014,20(6):464-467.
酪氨酸激酶抑制剂与化疗交替联合治疗晚期肺腺癌的临床疗效
The Effect of Tyrosine Kinase Inhibitors Alternately Combined with Chemotherapy in the Treatment for Advanced Lung Adenocarcinoma
投稿时间:2014-01-02  
DOI:10.11735/j.issn.1671-170X.2014.06.B006
中文关键词:  肺肿瘤  酪氨酸激酶抑制剂  化疗
英文关键词:lung neoplasms  tyrosine kinase inhibitor  chemotherapy
基金项目:武汉市重点攻关计划(201161038347)
作者单位
王 礼 通城县人民医院 
吴月兵 湖北省肿瘤医院 
余伟江 湖北省肿瘤医院 
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中文摘要:
      摘 要:[目的] 探讨酪氨酸激酶抑制剂(TKI)与化疗异时联合治疗晚期肺腺癌患者的疗效和不良反应。[方法]收集66例晚期肺腺癌患者,应用含铂2药化疗,疾病进展时予TKI吉非替尼或厄罗替尼治疗,或TKI初始治疗进展后使用化疗;交替进行。总生存时间及不良反应为主要观察指标。[结果] 66例患者中,58例是化疗—TKI治疗模式,再化疗的有效率为15.5%,8例是TKI—化疗模式,再次TKI的有效率为25.0%,稍高于化疗—化疗模式患者中第二次治疗的有效率(12.7%)(χ2=2.6,P=0.08)。化疗—TKI治疗与TKI—化疗患者的中位总体生存期(OS)无明显差异(18.3个月 vs 17.5个月)(P=0.44),但明显长于化疗—化疗患者(6.9个月)(P=0.0001)。交替治疗患者的3~4度不良反应与对照人群相似。[结论] 晚期肺腺癌患者TKI与化疗交替联合治疗能提高有效率,明显延长生存时间,与交替方式(给药顺序)无关。
英文摘要:
      Abstract:[Purpose] To investigate the efficacy and adverse reactions of TKI metachronously alternately combined with chemotherapy in patients with advanced lung adenocarcinoma. [Methods] A total of 66 patients with advanced lung adenocarcinoma patients treated with two-drug chemotherapy platinum-contained,and tyrosine kinase inhibitors(TKI) gefitinib or erlotinib,or TKI and chemotherapy alternately with disease progression after TKI initially. Thirty-one patients with lung adenocarcinoma were as control. The primary endpoints of the study were overall survival and adverse reactions.[Results] Of 66 patients,58 cases were chemotherapy-TKI treatment mode,and response rate of second chemotherapy was 15.5%. Eight cases with TKI-chemotherapy mode again,the TKI response rate was 25.0%. The median overall survival (OS) was not significantly different between chemotherapy-TKI therapy and TKI-chemotherapy(18.3 months vs 17.5 months,P=0.44);but significantly longer than that of the control adenocarcinoma population without TKI (6.9 months,P=0.0001). Side effects of grade 3~4 in alternately treated patients were similar to control subjects. [Conclusion] TKI alternately combined with chemotherapy is able to improve prognosis significantly,which does not relate to treatment modalities (sequence of administration) in patients with advanced lung adenocarcinoma.
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