The Effects Of Erlotinib In The Treatment For Advanced Non-small Cell Lung Cancer

Objective: To observe the efficacy and toxicity of chemotherapy and erlotinib in thetreatment for advanced non-small cell lung cancer(NSCLC).To evaluate the value oferlotinib in the treatment of NSCLC．Methods: From February2011to August2011,Total of57cases of definite diagnosedadvanced NSCLC patients with complete data were divided into a platinum-based twoagents combination chemotherapy group(30cases)，erlotinib group(27cases). Erlotinibgroup27cases: male17, female10cases, median age62years (32-72years),with ahistory of smoking14cases:male14, female0cases, non-smoking13cases,17cases ofadenocarcinoma,10non adenocarcinoma,8cases of ⅢB,19cases of IV, Six Patientswere treated as a first line treatment, Chemotherapy is ineffective or cannot tolerate theside effects of chemotherapy21cases. Chemotherapy group30cases: male21, female9cases, median age60years (41-87years), with a history of smoking17cases: male15,female2cases, non-smoking13cases,16cases of adenocarcinoma,14nonadenocarcinoma,13cases of ⅢB,17cases of IV, Regular follow-up these57cases. and toevaluate efficacy and adverse reactions according to the RECIST standard and WHOanticancer drug toxicity grading criteria.Results：57patients can all be evaluated efficacy.Erlotinib group27cases:CR1patient，PR8patients，SD10patients，PD8patients；objective response rate (ORR) was 33.3%,disease control rate(DCR) was70.4%; Chemotherapy group30cases:：CR0patient, PR5patients（16.6%）, SD11patients（36.7%），PD14patients（46.7%），objective response rate (ORR) was16.6%,disease control rate(DCR) was53.3%;There isno difference between Erlotinib group and Chemotherapy group with Comprehensiveevaluation on the objective response rate and disease control rate.on long-term efficacy,Progression-free Survival period (PFS) was5.7month (Erlotinib group:6.6month，Chemotherapy group:5.2month， P＞0.05), Mediea survival time(MST)was9.2month(Erlotinib group:10.9month，Chemotherapy group:7.9month，P＜0.05)，1yearsurvival rate was47.4%(Erlotinib group was51.9%，Chemotherapy group was43.3%)；The side-effect of Gefitinib is lighter，including mild or moderate rash (grade I:12cases,grade Ⅱ:3cases),The occurrence rate of Severe rash (≥grade Ⅲ,3cases) is verylow，and the rash general can be self-healed, reappear or disappear with the end oftreatment, Gastrointestinal reaction was basically divided intoⅠ,Ⅱ grade (incidencerate was40.7%,11/27); then was inhibition of bone marrow (3.71%,1/27), interstitialpneumonia (3.71%,1/27) and so on;The main side-effect of chemotherapy group werebone marrow suppression (76.7%,23/30),Gastrointestinal reaction （80%，24/30），thereware a small number of patients with skin rash (grade I3cases, grade Ⅱ1cases,13.3%,4/30), oral mucositis (23.3%,7/30),and so on. We found that the side-effect oftwo groups patients has statistical significance after the obtained data were statisticallyanalyzed.Conclusion:1.Erlotinib drug can be as one of first-line option for advanced non-small celllung cancer patients whose age was≥60years old and KPS score is low or not toleratechemotherapy.2.After Erlotinib used for advanced non-small cell lung cancer patientswith failure of chemotherapy, there were no significant difference for objective responserate (ORR),disease control rate(DCR),Progression-free Survival period (PFS),1yearsurvival rate between Erlotinib group and chemotherapy group.But the Mediea survivaltime(MST) of Erlotinib group was obviously better than chemotherapy group（10.9个月 vs7.9个月）.Therefor Erlotinib drug can be as one of second-line option for advancednon-small cell lung cancer3.Compared with chemotherapy group,the Erlotinib grouppatients has better effectiveness,clinical benefit rate and lighter adverse reaction thanchemotherapy group patients,it has good compliance and can comprehensive improve thepatients’quality of life.