| Objective: In recent years, numerous studies showed that epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (EGFR-TKI) erlotinib (Erlotinib, 0SI-774. Trade name: Tarceva) chemotherapy in the treatment of advanced NSCLCAfter the failure of the second and third line therapy achieved a significant effect.III clinical trial (BR.21) and IV clinical trials (TRUST) confirmed erlotinib in second-line treatment of advanced NSCLC has obvious benefits, has made significant PFS improvement.This study was admitted to our hospital with advanced non-small cell lung cancer patients treated with the failure of erlotinib for second-line treatment, to evaluate the clinical efficacy and adverse reactions.Methods: From June 2008 to April 2010 ,In First Affiliated Hospital of Dalian Medical University, admitted 60 patients with complete dataâ…¢B,â…¢of advanced non-small cell lung cancer patients received second-line treatment, oral erlotinib 150mg, daily1, until the show progress or serious disease can not tolerate the side effects.This study enrolled 60 patients, male 39, female 21 cases, median age 65 years (36 -78 years), 38 cases of adenocarcinoma, 22 squamous cell carcinomas, ECOG score of 0-1 in 39 cases,2 points in 21 cases, of which 27 casesâ…¢B,â…¢of 33 cases, 34 cases of previous smokers, 26 cases of non-smokers.Before treatment, patients underwent chest CT, abdominal CT, brain MRI, tumor markers, blood and liver and kidney function and other tests as a baseline assessment.Observed during the treatment of clinical symptoms, physical signs, treatment for 6 weeks after the physical and chemical examination, imaging evaluation of efficacy, efficacy was evaluated after every 6 weeks once, and evaluation criteria by Solid Tumors (RECIST criteria) efficacy evaluation of the patientdivided into complete remission (CR), partial remission (PR), stable (SD) and progression (PD).According to NCI common toxicity grading criteria (third edition) Evaluation adverse reactions. Results: 60 patients evaluable for efficacy, no efficacy to CR patients, PR was 14 cases (23.3%), SD 30 patients (50.0%), objective response rate (ORR) was 23.3%, disease control rate(DCR) was 73.3%; PD 16 cases (26.7%), median progression-free survival (mPFS) was 5.5 months, median survival time (MST) was 12.5 months and 1 year survival rate was 62.5%.Between the two groups showed that gender, age, pathological type, tumor stage at the ORR and DCR were no significant efficacy differences, P> 0.05; while on the DCR, PS score 0-1 score 2 points better than the PS patients (89.8% vs.42.8%, P = 0.007), non-smokers better than smokers (91.2% vs.50.0%, P = 0.018), the difference was statistically significant.Log-rank test line Univariate survival analysis of differences, statistical analysis showed age, adenocarcinoma, PS score, disease stage, smoking status and recent progress in the absence of effect of the difference in survival was statistically significant, P <0.05, while the median survival, PS score, disease stage, smoking status was statistically significant difference, P <0.05.Erlotinib common adverse reactions are mild, mostlyâ… ,â…¡degree of skin toxicity and diarrhea, no adverse reactions due to reduction or withdrawal.Observed adverse reactions were rash 78.3% (47/60), diarrhea 51.7% (31/60), followed by loss of appetite 38.3.% (23/60), pruritus 26.7% (16/60), nausea 30.0% (18/60), dry skin, 23.3% (14/60), vomiting 20.0% (12/60), 13.3% of oral mucositis (8/60), abnormal liver function (ALT, AST increase) 13.3% (8/60),abdominal pain 8.3% (5/60), all patients with no interstitial pneumoand blood toxicity occured.Conclusion: As the good effectiveness, accepted toxicity and oral convenience, erlotinib can be used as second-line therapy in selected patients with advancednon-small cell lung cancer. |
