厄洛替尼联合塞来昔布治疗晚期非小细胞肺癌的临床观察.doc

厄洛替尼联合贝伐单抗治疗晚期非小细胞肺癌的临床观察 熊德明1，贾茜1，李刚1，刘学芬1，冉文华1 1重庆市三峡中心医院肿瘤防治研究所，重庆 404000 摘要：目的 观察研究厄洛替尼联合贝伐单抗治疗晚期非小细胞肺癌的临床疗效及毒副反应。方法 选取35例晚期非小细胞肺癌患者，给予厄洛替尼每日150mg/d口服，贝伐单抗15mg/kg静脉滴注，21天一个周期，直至疾病进展，观察记录近期疗效及毒副反应。结果 35例患者中完全缓解0例，部分缓解16例，稳定12例，进展7例，疾病控制率为80%。主要毒副反应为皮疹、腹泻以及出血，发生率分别为77.1%，42.9%，22.9%。结论 厄洛替尼联合贝伐单抗能有效的治疗晚期非小细胞肺癌，且毒副反应较轻。 关键词：厄洛替尼；贝伐单抗；非小细胞肺癌；疗效；毒副反应 Clinical observation of combined erlotinib with bevacizumab in advanced non-small cell lung cancer patients Xiong Deming1, Jia Qian1, Li Gang1, Liu Xuefen1, Ran Wenhua1 1Institute for cancer prevention and treatment, Chongqing three gorges central hospital, Chongqing 404000 Abstract: Objective To evaluate the curative effect and adverse reactions of combined erlotinib with bevacizumab in advanced non-small cell lung cancer patients. Methods Thirty-five patients with advanced NSCLC were enrolled in this study. Erlotinib (150 mg) was orally administered daily, and bevacizumab (15mg/kg) was injected, 21 days as a cycle. Results There were zero patients who got complete remission, sixteen patients who got partial remission and twelve patients whose condition was stable, the disease control rate is 80%. The major adverse reactions of this study were skin rash, 基金项目：重庆市医学重点研究室建设项目资助（No. 2007-14） 通讯作者：熊德明 E-mail：teamo512@ diarrhea and bleeding, the incidence of them are 77.1%，42.9% and 22.9% separately. Conclusion Combined erlotinib with bevacizumab are effective in the treatment of advanced NSCLC, and the adverse reactions are minor. Keywords: erlotinib; bevacizumab; non-small cell lung cancer; clinic efficacy; adverse reactions 肺癌已成为全世界最主要的肿瘤，不管是从发生率还是从致死率看，均居各种肿瘤的首位[1]。在我国，肺癌的发病率及致死率仍具有上升的趋势，其致死率占全部恶性肿瘤致死原因的22.7%[2]。肺癌早期多无明显症状，故其早期诊断仍较困难，多数患者在确诊时，已经是肺癌晚期。因此，肺癌的总体5年生存率较低[3]。非小细胞肺癌（non-small cell lung cancer, NSCLC）在肺癌中约占70% ~80%[4]，且预后差，化疗疗效有限，中位生存8~10个月，有效率约为30%，1年生存率约40%[5]。分子靶向药厄洛替尼（erlotinib, 特罗凯，Tarceva）是一种1型人表皮生长因子受体/表皮生长因子受体（HER1/EGFR）酪氨酸激酶抑制剂，是化疗失败后晚期NSCLC患者的三线治疗药物。贝伐单抗（bevacizumab, Avastin）是一类重组人IgG1单克隆抗体，可以与血管内皮生长