目的：探讨吉非替尼（gefitinib）治疗化疗失败的晚期非小细胞肺癌（non-small cell lung cancer, NSCLC）患者的疗效和毒性反应。方法：收集2005年6月至2009年8月期间我科收治的64例晚期 NSCLC患者，接受吉非替尼治疗，250 mg每天顿服，直至病情进展或因不良反应而终止治疗，观察患者的临床疗效和不良反应。结果：64例晚期NSCLC患者中，无1例CR，PR 22例，SD 23例，PD 19例，全组有效率（CR+PR）为34.38％，疾病稳定率为35.94％，疾病控制率（CR+PR+SD）为70.31％。中位生存期为5.9个月，截止随访时间35.94％（23/64）的患者仍存活。吉非替尼的疗效与性别及吸烟史相关（P＜005），女性疗效优于男性（P<0.05），无吸烟史优于有吸烟史。最常见的药物不良反应主要表现为Ⅰ、Ⅱ度皮疹（32.81％、26.57％）、腹泻（12.5％）。结论：对于化疗失败的晚期 NSCLC，吉非替尼能较好地缓解女性、腺癌、未吸烟患者的疾病相关症状，是一种安全、有效并具有较好耐受性的药物。

Objective:To observe the clinical effects and toxicity of gefitinib in treatment of patients with advanced non-small cell lung cancer (NSCLC) who failed to respond to prior chemotherapy. Methods: Sixty-four patients with advanced NSCLC were admitted to our hospital from Jun. 2005 to Aug. 2009. Gefitinib was given orally (250 mg) once daily to NSCLC patients until disease progression or the development of intolerable toxicity, and the clinical results were observed. Results: No patients showed complete response (CR), 22 patients showed partial response (PR), 23 patients maintained stable disease (SD), and 19 patients had disease progression (PD), with the overall response rate (CR+PR) being 34.38%, the stability disease rate being 35.94%, and disease control rate (CR+PR+SD) being 70.31%. The median survival period in our group was 5.9 months. Twenty-three patients of 64 (35.94％) were alive till the follow-up time. The effect of gefitinib was associated with gender and smoking (P<0.05), with better effect seen in females and non-smokers. The most common drug-related adverse events included grade ⅠorⅡ skin rash (32.81％, 26.57％) and diarrhea (12.5％). Conclusion:Gefitinib can relieve NCSLC-related symptoms in chemotherapy-resistant advanced NCSLC patients, especially in females and non-smokers; it is a safety, effective, and tolerable drug.

新疆医科大学青年创新基金项目（No.XJC201032)