吉非替尼治疗非小细胞肺癌致间质性肺炎的研究进展

发布时间：2018-03-17 08:37

本文选题：吉非替尼　切入点：非小细胞肺癌　出处：《中国药房》2017年05期 　论文类型：期刊论文

【摘要】：目的:了解吉非替尼治疗非小细胞肺癌(NSCLC)致间质性肺炎(ILD)的研究进展。方法:查阅近年来国内外相关文献,就吉非替尼的作用机制、药动学和药效学特征,以及吉非替尼治疗NSCLC致ILD的发病率、发病机制、临床诊断、治疗和预后的研究进行归纳和总结。结果:吉非替尼致ILD是其治疗NSCLC罕见却致命的严重的不良反应,确切的发病机制尚不清楚,临床需了解与其相关的高危因素。当吉非替尼治疗NSCLC致ILD确诊后,必须立即停用吉非替尼,及时给予糖皮质激素抑制ILD向肺纤维化转变;症状较严重者可先选择大剂量激素冲击疗法,而后改为常规剂量并逐渐减量;对糖皮质激素治疗效果不佳或者不耐受的患者,可考虑使用免疫抑制剂或细胞毒性药物治疗,并同时给予对症治疗。为了增加疗效并改善患者生活质量、减轻不良反应,可在常规西医治疗的基础上联合补肺益气、活血化瘀、软坚散结的中药治疗,以最大限度提高患者生存质量。结论:临床应重视吉非替尼治疗NSCLC致ILD的严重不良反应,早预防、早发现、早诊断和早治疗。
[Abstract]:Objective: to investigate the progress in the treatment of interstitial pneumonia (ILD) caused by gifitinib in the treatment of NSCLC. Methods: to investigate the mechanism, pharmacokinetics and pharmacodynamics of gifitinib in recent years. The incidence, pathogenesis, clinical diagnosis, treatment and prognosis of ILD caused by gifitinib were summarized and summarized. Results: gifetini induced ILD was a rare but fatal adverse reaction in the treatment of NSCLC. The exact pathogenesis is not clear, the clinical need to understand its related high risk factors. When gifitinib treatment of NSCLC induced ILD diagnosis, we must immediately stop gifitinib, timely administration of glucocorticoid to inhibit ILD to pulmonary fibrosis; Those with severe symptoms may first choose high-dose hormone shock therapy, and then change to routine doses and gradually reduce their dose; for patients with poor or intolerant glucocorticoid treatment, they may consider using immunosuppressants or cytotoxic drugs. In order to increase the curative effect and improve the quality of life of the patients, and alleviate the adverse reactions, we can combine the traditional Chinese medicine treatment of tonifying the lung and invigorating qi, activating blood circulation and removing blood stasis, and softening and dispersing the knot on the basis of routine western medicine treatment. Conclusion: we should pay attention to the treatment of severe adverse reactions of ILD caused by NSCLC early prevention early detection early diagnosis and early treatment.
【作者单位】：首都医科大学附属北京中医医院肿瘤科;
【基金】：国家自然科学基金资助项目(No.81473643) 北京市科技计划项目(No.D161100005116005) 北京市医院管理局临床技术创新项目(No.XMLX201410)
【分类号】：R734.2;R563.13

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