CAJ | 학술논문

背景与目的表皮生长因子受体酪氨酸激酶抑制剂（epidermal growth factor receptor tyrosine kinase inhibi-tors, EGFR-TKIs）目前广泛应用于晚期非小细胞肺癌（non-small cell lung cancer, NSCLC），特别是存在表皮生长因子受体EGFR基因突变的肺腺癌患者。对于治疗后进展的患者，后续治疗未取得共识。本文总结EGFR-TKIs治疗后缓慢进展的晚期NSCLC患者接受不同后续治疗方法的近期疗效、毒性反应和总生存期，评价不同治疗方法的意义。方法回顾性分析我院2003年9月-2011年12月期间32例接受EGFR-TKIs治疗后缓慢进展的晚期NSCLC患者，分别继续接受EGFR-TKIs治疗或化疗。结果 EGFR-TKIs维持治疗组患者的中位生存时间为36.0个月，在改行化疗的患者中，化疗有效率为43.75%，总的临床获益率（完全缓解+部分缓解+稳定）为87.5%。中位生存时间为15.5个月。主要的毒性反应为恶心呕吐等消化道反应和血液学毒性。结论在EGFR-TKIs治疗后出现肿瘤缓慢进展的患者中，维持原EGFR-TKIs治疗是可行的选择。
배경여목적표피생장인자수체락안산격매억제제（epidermal growth factor receptor tyrosine kinase inhibi-tors, EGFR-TKIs）목전엄범응용우만기비소세포폐암（non-small cell lung cancer, NSCLC），특별시존재표피생장인자수체EGFR기인돌변적폐선암환자。대우치료후진전적환자，후속치료미취득공식。본문총결EGFR-TKIs치료후완만진전적만기NSCLC환자접수불동후속치료방법적근기료효、독성반응화총생존기，평개불동치료방법적의의。방법회고성분석아원2003년9월-2011년12월기간32례접수EGFR-TKIs치료후완만진전적만기NSCLC환자，분별계속접수EGFR-TKIs치료혹화료。결과 EGFR-TKIs유지치료조환자적중위생존시간위36.0개월，재개행화료적환자중，화료유효솔위43.75%，총적림상획익솔（완전완해+부분완해+은정）위87.5%。중위생존시간위15.5개월。주요적독성반응위악심구토등소화도반응화혈액학독성。결론재EGFR-TKIs치료후출현종류완만진전적환자중，유지원EGFR-TKIs치료시가행적선택。
Background and objective hTe epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have been widely used in the treatment of the advanced non-small cell lung cancer (NSCLC), especially in the adeno-carcinoma patients with activating EGFR mutations. But there is no published overview of the following treatment. hTis report through observing the efficacy, toxicity and overall survival of different treatments to the advanced NSCLC patients who had gradual progression atfer EGFR-TKIs, evaluates the inlfuence of the continued treatment and switching chemotherapy. Methods Retrospective review is conducted on 32 cases of advanced NSCLC patients who experienced treatment failure of EGFR-TKIs. One group accepted the continued treatment and the other group accepted the switching chemotherapy. Results hTe median overall survival of the continued treatment group is 36.0 months. hTe respose rate of the switching chemotherapy group is 43.75%, and clinical benefit rate (complete and partial response and stable disease) is 87.5%. The median overall survival is 15.5 months. hTe main toxicities are nausea, vomiting and hematological toxicities. Conclusion For the advanced NSCLC patients who had gradual progression atfer EGFR-TKIs, the continued treatment is one of the acceptable choices.