摘要目的 分析表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)治疗失败后晚期非小细胞肺癌(NSCLC)化疗的疗效.方法 回顾性分析2005年1月至2006年12月EGFR-TKI治疗失败后接受化疗的87例晚期NSCLC患者的临床资料,其中男性37例,年龄31～76岁,平均56±11岁;女性50例,年龄31～78岁,平均56±13岁.双药化疗者61例,单药化疗者26例.主要研究终点为总生存期(OS),次要研究终点为有效率(ORR)及不良反应.结果 全部患者OS为9.4±6.0(范围2～33)个月,ORR为9.2%(8/87).双药组OS为9.1±5.2(范围2～31)个月,ORR为11.5%(7/61);单药组OS为10.0±7.3(范围3～33)个月;ORR为3.8%(1/26);两组比较差异均无统计学意义(P＞0.05).化疗常见不良反应主要为骨髓抑制和胃肠道反应,骨髓抑制发生率为87.4%(76/87),其中3/4度骨髓抑制发生率为33.3%(29/87);胃肠道反应发生率为86.2%(75/87),其中3度胃肠道反应10.3%(9/87).结论 晚期NSCLC患者EGFR-TKI治疗失败后化疗可使OS延长;只要患者能够耐受就应积极给予化疗.

abstractsObjective To analyze the treatment efficacy after a failed regimen of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) in patients with advanced non-small cell lung carcinoma (NSCLC).Methods A retrospective analysis was conducted for 87 patients with advanced NSCLC at our hospital from January of 2005 to December of 2006.All subjects received chemotherapy after a failure of EGFR-TKI,there were 37 cases of male and the median age was 56 ± 11 ( range,31-76) years,50 cases of female,median age 56±13 (range,31-78) years; They received a 2-drug combination chemotherapy (n=61) and a monodrug chemotherapy (n = 26).The primary endpoint was overall survival (OS).And the secondary endpoints were objective response rate (ORR) and side effects.Results The OS was9.4±6.0(range,2-33) months and ORR 9.2%(8/87).The OS was 9.1±5.2 (range,2-31)months in combination chemotherapy group and 10.0±7.3(range,3-33) months in monodrug group; the ORRs were 11.5%(7/61) and 3.8%(1/26) respectively in two groups.There was no significant difference in OS and ORR between two groups ( P ＞0.05 ).The common side effects were myelosuppression and nausea/vomiting.The rate of myelosuppression was 87.4%(76/87) and that of 3/4 grade myelosuppression 33.3% (29/87).And the rate of nausea/vomiting was 86.2% (75/87) and that of 3/4 grade nausea/vomiting 10.3% (9/87).Other side effects were mild and well-tolerated.Conclusion If tolerated,chemotherapy after an EGFR-TKI failure may prolong the survival in advanced NSCLC patients.