摘要
目的观察吉非替尼治疗老年表皮生长因子受体(EGFR)基因突变阳性肺腺癌恶性胸腔积液的疗效。方法选择肺腺癌伴恶性胸腔积液老年患者48例,按胸水EGFR基因突变检测结果将患者分为2组:观察组(n=20)和对照组(n=28),观察组为突变阳性患者,对照组为突变阴性患者。观察组引流胸腔积液后给予口服吉非替尼,对照组以胸腔内注入顺铂治疗。对比2组患者治疗前及治疗后1、2及3个月胸腔积液控制情况、肿瘤患者生存质量评分(KPS评分)、血清癌胚抗原(CEA)及糖类抗原125(CA125)水平、血常规、肝肾功能指标、无进展生存期(PFS)和总生存期(OS)等指标,评定吉非替尼疗效及不良反应。结果治疗后观察组胸腔积液在各时间点都有不同程度的吸收,而对照组吸收不明显;观察组有效率(90.00%)高于对照组(28.57%)(P<0.05);治疗后观察组KPS评分提高,各时间点均高于对照组。治疗3个月时,观察组CEA及CA125较对照组明显下降,观察组患者的中位OS及FS均明显长于对照组(P<0.05)。结论吉非替尼治疗老年EGFR突变阳性肺腺癌恶性胸腔积液患者,可较快减轻患者症状,提高生存质量,并延长生存期。
Objective To study the effects of gefitinib in the treatment of malignant pleural effusion in elderly patients with of epidermal growth factor receptor(EGFR)mutation positive lung adenocarcinoma.Methods 48 elderly patients with lung adenocarcinoma and malignant pleural effusion were selected and divided,according to the results of EGFR gene mutation detection in pleural effusion,into two groups:20 cases in the observation group with positive mutation and 28 cases in the control group with negative mutation.The observation group was given oral gefitinib after drainage of pleural effusion,and the control group was treated with cisplatin by intrapleural injection.The control of pleural effusion,Karnofsky performance score(KPS),serum carcinoembryonic antigen(CEA)and carbohydrate antigen 125(CA125)levels,routine blood tests,liver and kidney function,progression-free survival(PFS)and overall survival(OS)were compared between two groups before treatment and1,2 and 3 months after treatment and the effects and adverse reactions of gefitinib were evaluated.Results After treatment,the pleural effusion in the observation group was absorbed to varying degrees at each time point,while the control group was not significantly.The effective rate of the observation group(90.00%)was higher than that of the control group(28.57%)(P<0.05).After the treatment,KPS score of the observation group was higher than that of the control group at all time points.At 3 months of treatment,the CEA and CA125 of the observation group were significantly lower than those of the control group,and the median OS and FS of the observation group were significantly longer than those of the control group(P<0.05).Conclusion Gefitinib can relieve the symptoms,improve the quality of life and prolong the life of the elderly patients with EGFR mutation positive lung adenocarcinoma malignant pleural effusion.
作者
钟杉
夏元旦
沈美珠
徐丽
曹睿杰
周璇
王传翠
周敏
Zhong Shan;Xia Yuandan;Shen Meizhu;Xu Li;Cao Ruijie;Zhou Xuan;Wang Chuancui;Zhou Min(Department of RespiratoryMedicine,Jinshan Branch of the Sixth People's Hospital of Shanghai City,Shanghai 2,01599,P.R.China;Department of Medicine,Zhongren Aged Care Hospital of Jinshan District,Shanghai,201501,P.R.China)
出处
《老年医学与保健》
CAS
2020年第3期390-392,417,共4页
Geriatrics & Health Care
基金
上海市金山区第六周期医学重点专科建设项目(JSZK2019A04)。
关键词
老年
肺腺癌
吉非替尼
恶性
胸腔积液
表皮生长因子受体
elderly
lung adenocarcinoma
gefitinib
malignant
pleural effusion
epidermal growth factor receptor
作者简介
通信作者:周敏,电子信箱:zhoumin-1209@163.com。
