[1]杨庆羚,刘翩,王斌,等.EGFR-TKIs治疗晚期非小细胞肺癌并发间质性肺炎4例报告并文献复习[J].陆军军医大学学报(原第三军医大学学报),2012,34(20):2060-2062.
　Yang Qingling,Liu Pian,Wang Bin,et al.Interstitial pneumonia in EGFR-TKIs-treated non-small-cell lung cancer: report of 4 cases and review of the literature[J].J Amry Med Univ (J Third Mil Med Univ),2012,34(20):2060-2062.
点击复制

EGFR-TKIs治疗晚期非小细胞肺癌并发间质性肺炎4例报告并文献复习(/HTML )
分享到：

陆军军医大学学报（原第三军医大学学报）[ISSN:1000-5404/CN:51-1095/R]

卷:
34卷
期数:
2012年第20期
页码:
2060-2062
栏目:
论著
出版日期:
2012-10-30

文章信息/Info

Title:
Interstitial pneumonia in EGFR-TKIs-treated non-small-cell lung cancer: report of 4 cases and review of the literature
作者:
杨庆羚; 刘翩; 王斌; 李运成; 范晔; 吴国明
第三军医大学新桥医院呼吸内科，全军呼吸内科研究所，全军呼吸病研究重点实验室
Author(s):
Yang Qingling;  Liu Pian;  Wang Bin;  Li Yuncheng;  Fan Ye;  Wu Guoming
Department of Respiratory Diseases, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China
关键词:
非小细胞肺癌; 表皮生长因子受体; 酪氨酸激酶抑制剂; 间质性肺炎
Keywords:
non-small cell lung cancer; epidermal growth factor receptor; tyrosine kinase inhibitors;  interstitial pneumonia
分类号:
R563.13；R734.2；R979.1
文献标志码:
A
摘要:
目的      总结表皮生长因子受体酪氨酸激酶抑制剂（epidermal growth factor receptor tyrosine kinase inhibitors，EGFR-TKIs）在治疗晚期非小细胞肺癌（non-small cell lung cancer，NSCLC）中所致间质性肺炎的临床表现、诊断和治疗。      方法      回顾性分析我科4例晚期NSCLC患者靶向治疗药物致间质性肺炎的临床表现、诊断、治疗经过及转归。      结果      4例晚期NSCLC患者均接受了化疗，并分别因化疗后病情进展或不能耐受进一步化疗而口服吉非替尼或厄洛替尼，在EGFR-TKIs治疗后30 d内出现呼吸困难、咳嗽和低氧血症，并发间质性肺炎，其中3例病情进展迅速，因呼吸衰竭死亡，提示其预后凶险。      结论      对接受EGFR-TKIs治疗的患者，一旦出现呼吸困难和咳嗽，应及时进行胸部CT、肺功能、血气分析等相关检查。该类间质性肺炎预后凶险，病死率很高，一旦确诊间质性肺炎，应立即停用EGFR-TKIs，并及时予以足量激素及氧疗等对症治疗，必要时进行呼吸支持，才有可能改善其预后。
Abstract:
Objective      To identify the clinical features, diagnosis and treatment of interstitial pneumonia related to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) which were used in advanced non-small cell lung cancer(NSCLC).       Methods      Retrospective analysis was carried out in 4 cases with NSCLC who developed interstitial pneumonia after EGFR-TKIs therapy in our department from March 2007 to September 2011. Their clinical features, diagnosis, treatment and outcome were analyzed.       Results      The 4 patients had previously received chemotherapy until disease progression or unacceptable toxicity and then turned to receive gefitinib or erlotinib orally. However, within 30 d after the treatment, the patients suffered from dyspnea, cough and hypoxemia and developed interstitial pneumonia. Three patients died of respiratory failure due to rapid disease progression, which reflected the poor prognosis of the interstitial pneumonia.        Conclusion      EGFR-TKIs-related interstitial pneumonia is with poor prognosis and high mortality. Timely chest CT scanning, pulmonary function testing, blood gas analysis and other tests should be performed as soon as dyspnea, cough and hypoxemia are seen. Relevant treatment such as discontinuation of EGFR-TKIs immediately, use of corticosteroids, oxygen therapy and respiration supporting when necessary, can probably improve the prognosis and survival of patients.

相似文献/References:

[1]刁鑫伟,叶明福,谢启超,等.二氢睾酮对前列腺癌LNcap和PC-3细胞株EGFR mRNA表达的影响[J].陆军军医大学学报(原第三军医大学学报),2005,27(16):1690.
[2]王孟昭,张紫萱.肺癌的靶向治疗[J].陆军军医大学学报(原第三军医大学学报),2012,34(20):2035.
　Wang Mengzhao,Zhang Zixuan.Target therapy in lung cancer[J].J Amry Med Univ (J Third Mil Med Univ),2012,34(20):2035.
[3]蒋娟,易亭伍,张瑜,等.非小细胞肺癌的肿瘤干细胞与非肿瘤干细胞中表皮生长因子受体基因异质性的研究[J].陆军军医大学学报(原第三军医大学学报),2012,34(20):2039.
　Jiang Juan,Yi Tingwu,Zhang Yu,et al.Genetic heterogeneity of EGFR in cancer and non-cancer stem cells from non-small cell lung cancer[J].J Amry Med Univ (J Third Mil Med Univ),2012,34(20):2039.
[4]斯晓燕,张力.西妥昔单抗联合化疗一线治疗非小细胞肺癌20例临床观察[J].陆军军医大学学报(原第三军医大学学报),2012,34(20):2063.
　Si Xiaoyan,Zhang Li.Outcomes of cetuximab combined with chemotherapy as first line therapy in 20 patients with non-small cell lung cancer[J].J Amry Med Univ (J Third Mil Med Univ),2012,34(20):2063.
[5]罗虎,罗丹,宫亮,等.联合CIK细胞与化疗对比单纯化疗治疗中晚期非小细胞肺癌的Meta分析[J].陆军军医大学学报(原第三军医大学学报),2012,34(20):2119.
[6]刘瑞青,申淑景,马杰,等.肺腺癌组织中TTF-1和SPA的表达对EGFR突变的临床预测价值[J].陆军军医大学学报(原第三军医大学学报),2012,34(22):2314.
　Liu Ruiqing,Shen Shujing,Ma Jie,et al.Clinical value of TTF-1 and SPA expression in predicting EGFR mutations in lung adenocarcinoma[J].J Amry Med Univ (J Third Mil Med Univ),2012,34(20):2314.
[7]张瑞萍,吴继华,黄英武,等.循环肿瘤细胞检测指导老年非小细胞肺癌个体化治疗1例[J].陆军军医大学学报(原第三军医大学学报),2012,34(22):2248.
[8]闫霞,曹官铭,王导新.吉西他滨联合卡铂治疗老年非小细胞肺癌的临床评价[J].陆军军医大学学报(原第三军医大学学报),2007,29(19):1913.
　YAN Xia,CAO Guan-min,WANG Dao-xin.Gemcitabine plus carboplatin regimen in treatment of advanced non-small cell lung cancer in aged patients[J].J Amry Med Univ (J Third Mil Med Univ),2007,29(20):1913.
[9]闵发胜,陈正堂.人非小细胞肺癌与外周血淋巴细胞表达LRP的相关性研究[J].陆军军医大学学报(原第三军医大学学报),2007,29(17):1699.
　MIN Fa-sheng,CHEN Zheng-tang.Correlation between expression of lung resistance-related protein in non-small cell lung cancer and that in peripheral blood lymphocytes[J].J Amry Med Univ (J Third Mil Med Univ),2007,29(20):1699.
[10]高娟,饶进军,吴少瑜,等.丁酸钠与顺铂联用对非小细胞性肺癌细胞生长的抑制作用[J].陆军军医大学学报(原第三军医大学学报),2007,29(11):1066.
　GAO Juan,RAO Jin-jun,WU Shao-yu,et al.Combination of sodium butyrate and cisplatin has antiproliferative effects on non-small lung cancer cell line[J].J Amry Med Univ (J Third Mil Med Univ),2007,29(20):1066.
[11]肖何,王阁,杨镇洲,等.非小细胞肺癌ERCC1 C118T多态性与EGFR突变的相关性[J].陆军军医大学学报(原第三军医大学学报),2014,36(02):184.

更新日期/Last Update: 2012-10-18