易瑞沙耐药后的解决方案，请大家都来找出路

siye · 发表于 2007-6-29 21:00:39

父亲肺癌右腿骨转移,一直痛的厉害,易吃了两个月没效果,左胸开始痛了,呼吸多连着痛,转吃特罗凯已1个礼拜,没见有效果,前两天打了第三针唑来磷酸,这两天腿部更加疼痛,不知道过些日子会不会好些,已经第三针唑来磷酸了怎么感觉一点止痛效果也没有啊,真不知道以后该怎么办了,父亲每天精神多不好,胃口更不好,还要吃很多的止痛药,该如何,请患友门指点啊!不知唯美生对我父亲是否有效.我就怕副反应啊,老爸对什么药多很过敏的. 我父亲现在不仅腿疼的厉害,心率也不齐了,三个礼拜前开始的,每天早上和晚上多来几次早博,有时是房颤,这几天更厉害了,特别是房颤,父亲人很不舒服.怎么办啊兄弟姐妹们.

ljxsq · 发表于 2007-7-2 15:34:20

我母亲肺腺癌晚期，没做过放化疗，也没手术（不能手术），已经扩散到胸腔，打阿奇霉素都有药物反应，准备给她吃易瑞莎，听说同时吃灵芝袍子油能保肝，不知有人试过吗？

jimmy112199 · 发表于 2007-7-4 06:54:56

<h2>A case of lung adenocarcinoma of the lung with disappearance of brain
metastasis by re-treatment with gefitinib</h2>

[Article in Japanese]

<a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Kato%20T%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus">Kato
T</a>, <a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Nakashima%20M%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus">Nakashima
M</a>, <a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Yoshimura%20K%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus">Yoshimura
K</a>, <a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Imao%20M%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus">Imao
M</a>, <a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Goto%20H%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus">Goto
H</a>, <a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Yasuda%20S%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus">Yasuda
S</a>, <a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Sano%20K%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus">Sano
K</a>.

Respirtory Medicine, <st1place><st1placename>National</st1placename>
<st1placetype>Hospital</st1placetype>
<st1placename>Nagara</st1placename>
<st1placename>Medical</st1placename>
<st1placetype>Center</st1placetype></st1place>.

BACKGROUND: Tumor response rate to gefitinib by previously
treated patients with advanced non-small-cell lung cancer was approximately
20%. However, there are few reports about effect of re-treatment with gefitinib.
CASE: A 40-year-old man was given a diagnosis of adenocarcinoma of lung
(c-T2N3M1). Response was not obtained with chemotherapy (paclitaxel +
carboplatin, vinorelbine + gencitabin). He developed brain metastasis and
received whole brain radiation therapy. He was then given gefitinib. Reduction
of the primary tumor, brain metastasis, pulmonary metastasis and liver
metastasis was seen. Recurrence of pulmonary metastasis and liver metastasis
was discovered 8 months after treatment with gefitinib. Therefore, treatment by
gefitinib was stopped. Response was not achieved with chemotherapy (docetaxel
and amrubicin). At the request of the patient, retreatment with gefitinib was
resumed. Disappearance of brain metastasis was achieved. However, primary tumor,
pulmonary metastasis and liver metastasis progressed. CONCLUSION: We reported a
case whose brain metastases disappeared with re-treatment with gefitinib. This
report is thought to be useful in terms of information about the acquired
resistance of gefitinib. Further investigations are needed to determine the
indication of re-treatment with gefitinib.

一
例肺腺癌并发脑转移, 重用IRESSA后脑转移完全消失的例子<op></op>

[原文为日文] 

加藤 T,  Nakashima M, 等<op></op>

国家医院长良医疗中心,
呼吸医学<op></op>

.背景:

对以往已治疗过晚期非小细胞肺癌肿瘤，IRESSA反应率为约占20%
. 但是,
只有少数重用IRESSA的报道. 

案例:

一个40岁男子被诊断为肺腺癌(C- t2n3m1 ) 化疗没有取得效果 (紫杉醇+卡铂,诺维gencitabin
+ ) . 他发展了脑转移，接受全脑放射治疗.
于是,他被给IRESSA治疗.原发性肿瘤,脑转移,肺转移和肝转移.减少。8个月治疗后，发现肺转移和肝转移复发.
因此,
停止IRESSA治疗. 后来的化疗(紫杉醇amrubicin
)
未取得效果 . 在病人提出要求下,IRESSA被恢复.脑转移达到完全消失. 然而,原发性肿瘤,肺转移和肝转移进展.

 结论:

本病例中，重用IRESSA后的脑转移瘤消失,. 这份报告被认为是有用的信息，当IRESSA获得抗药性. 进一步调查后才能确定重用IRESSA的作用范围。.

相信奇迹 · 发表于 2007-7-4 09:32:18

化疗很少有突破屏障作用到脑的，针对这个案例，我的感觉，意瑞沙对脑转的效果一直存在，但是已经无法控制肝转和肺内转，即使是化疗后复用还是无法控制。根据医生的评价标准，只要是进展了，无论是哪个部位，都视为意瑞沙耐药。

我爱妈妈 · 发表于 2007-7-12 10:05:37

我妈妈肺腺癌IV期，从07年3月7日开始服用易瑞莎，5月中旬检查病灶明显缩小；改服印度版；7月11日CT检查显示，原病灶（左肺）有扩展；右肺有新病变发生；但胸腔积液减少，最初的骨转移没有变化。难道4个月的时间就开始耐药了？我很痛苦：停止易瑞莎，改化疗方案，如果能坚持半年，再重新服用易瑞莎？请问各位有什么建议吗？拜谢了！

jimmy112199 · 发表于 2007-7-13 05:30:19

你是不是碰上假药了

小路 · 发表于 2007-7-13 07:32:20

印度NATCO公司在印度排在钢铁米塔尔公司之后，居第二。又属世界500强。

东方 · 发表于 2007-7-13 10:36:48

TO 我爱妈妈:你妈妈的医生看过CT怎么说?试试用回英国版易瑞沙,一个月后再拍片子检查,如果无进展说明英国版易瑞沙对你妈妈比较适用.

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易瑞沙 耐药后的解决方案，请大家都来找出路

易瑞沙耐药后的解决方案，请大家都来找出路