严重的急性间歇性肺炎和gefitinib
Akira Inoue1, Yasuo Saijo, Makoto Maemondo
1Department of Respiratory Oncology and Molecular Medicine, Institute of Development, Aging, and Cancer, Tohoku University, Aobaku, Sendai, 980-8575, Toyko, Japan. akinoue@idac.tohoku.ac.jp
Lancet (London, England)
|January 18, 2003
概括
吉菲提尼布是一种肺癌药物,可引起严重的急性间歇性肺炎. 医生应监测患者是否存在这种风险,特别是那些先前有胸部辐射或健康状况不佳的患者.
科学领域:
- 在瘤学瘤学.
- 肺部病理学 肺部病理学
- 药理学 药理学是指药理学的学科.
背景情况:
- 格菲提尼布是一种有效的向疗法,用于治疗高级非小细胞肺癌 (NSCLC) 的患者,这些患者对基化疗有耐药性.
- 像gefitinib这样的表皮生长因子受体 (EGFR) 氨酸激酶抑制剂在NSCLC治疗中取得了重大进展.
- 急性间歇性肺炎是一种与某些癌症疗法相关的严重潜在不良事件.
研究的目的:
- 报告和分析用gefitinib治疗的患者严重急性间歇性肺炎的病例.
- 为了确定与gefitinib诱导的肺损伤相关的潜在风险因素和临床特征.
- 提高临床医生对这种特定的gefitinib相关的肺毒性的认识.
主要方法:
- 对四名患有非小细胞肺癌的患者的病例系列评估,这些患者在接受gefitinib治疗期间经历了急性间歇性肺炎.
- 对临床数据,治疗反应,尸检结果和胸部CT扫描 (显示分散的地面玻璃不透明度) 的审查.
- 肺部发现与患者病史的相关性,包括先前的胸部照射和性能状态.
主要成果:
- 这四名患者都出现了严重的急性间歇性肺炎.
- 两名患者在接受皮质类固醇治疗后康复,而另外两名患者因呼吸衰竭而死亡.
- 尸检和CT扫描证实了与急性间歇性肺炎相一致的扩散膜损伤.
- 确定的风险因素包括先前的胸部照射和表现不佳的状态.
结论:
- 格菲提尼布可以诱导严重的,可能致命的,急性间歇性肺炎 (扩散膜损伤).
- 及时识别和管理,包括类固醇治疗,可能导致一些患者的康复.
- 医生必须对gefitinib诱导的肺损伤保持谨慎和提高意识,特别是在患有先前肺病或风险因素的患者中.
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