摘要
目的：提高对吉非替尼所致间质性肺病变（interstitial lung disease，ILD）的认识。方法：报告2例因吉非替尼所致ILD并引起死亡病例的临床和CT表现；回顾复习2003-2007年公开发表的中、英文关于吉非替尼不良反应报告的文献。结果：2例有多发转移的非小细胞肺癌患者均为男性，有长期吸烟史。分别于口服吉非替尼第7、18天后发现ILD，第11、25天后死亡。在胸部CT上2例均表现为两侧广泛的磨玻璃样肺实变，前部肺组织病变较轻、实变分布较少。在国内大约有574例使用吉非替尼的中文文献报道，发生ILD6例，无死亡病例。全球使用吉非替尼引起ILD的大约1％（在日本大约为2％，全球其他地区为0．3％），吉非替尼所致ILD的死亡率大约为1／3。结论：吉非替尼所致ILD是严重的、临床上不能忽略的不良反应。避免使用于高危人群和使用时定期行胸部影像学检查是必要的。
Objective： To enhance the consciousness to gefitinib-induced interstitial lung disease （ILD）. Methods： Clinical and CT findings of two cases with gefitinib-induced ILD and the induced death were reported. The Chinese and English literatures from 2003 to 2007 about adverse events of gefitinib were reviewed. Results： Two patients with non-small cell lung cancer （NSCLC） attended by multiple metastasis were males, long-term smokers. ILD was found 7 and 18 days and death happened 11 and 25 days after oral administration of 250 mg/day of gefitinib. There were extensive ground-glass airspace consolidations in bilateral lung area in 2 patients on the CT films. About 574 patients with NSCLC received gefitinib in China, 6 patients of them were induced ILD and none died based on Chinese literatures. Worldwide, the incidence of gefitinib-induced ILD was about 1 % （about 2% in Japan; 0.3 % in the rest of the world） and approximately one-third of the cases were dead. Conclusion： The gefitinib-induced ILD is a serious adverse effect in the clinical setting that can not be ignored. It is beneficial for the patients who are at high risk to avoid using gefitinib and for all patients who are using gefitinib to perform CT or plain X-ray films of the chest at regular intervals.
出处
《中国中西医结合影像学杂志》
2008年第4期241-243,共3页
Chinese Imaging Journal of Integrated Traditional and Western Medicine
关键词
吉非替尼
间质性肺病变
文献复习
Gefitinib
Interstitial lung disease
Literature review
