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肺癌靶向药物

ID #1016

易瑞沙使用总结

    看完易瑞沙的说明书以及总结患友们的使用情况后,个人有些对使用易瑞沙(IRESSA)的看法,总结为以下几点,希望对正在使用或者准备使用的朋友们一点建议:

1、易瑞沙与化疗联合使用并不能提高治疗效果,这是大家都知道的,而这里所指的化疗药物是包括铂类药物,而不能与长春瑞滨联合使用,长期同服会加剧长春瑞滨引起的中性白细胞较少作用;

2、易瑞沙是可以溶解在纯水中服用的;

3、与食物同服不影响易瑞沙的吸收;

4、最严重的副作用:间质性肺炎的发生概率为0.28%(通常表现为急性的呼吸困难,伴有咳嗽;低热,呼吸不适和动脉血氧不饱和);

5、易瑞沙对肝有影响,应定期检查肝功能。肝转氨酶轻中度胜概的患者慎用。

    出现任何眼部症状以及严重持续的腹泻、恶心、呕吐和厌食应立即就医.

    易瑞沙是原厂是英国阿斯利康公司,大家所说的吉非替尼也是该药,易瑞沙是一种治疗癌症的靶向治疗药物,一般是一、二线标准化疗无效后的三线药物,初次服用易瑞沙的患者,如果经济条件许可,最好还是先试用英国版,服用6个月可申请慈善赠药。

     若经济条件限制,可试用印度易瑞沙,疗效是差不多的,只是价格便宜很多。

    易瑞沙对于腺癌、不吸烟、女性患者的疗效要优于非此类型,但也并非绝对,一些病友是有多年吸烟史的男性,服用了也有效,而条件都符合的女性吃了也无效。

    但是以我个人浅薄之见,如果患者未接受标准治疗或者分期较好,还是应先以标准治疗为先,毕竟易瑞沙是最后一步不是办法的办法。而且服用易瑞沙的时机把握也很重要,有其他治疗方案可以选择的时候过早服用不好,因为这药吃了就不能断;而当病人一、二线方案都无效,身体状况很不好的时候,也不能犹豫。

    其实病友犹豫的原因不外乎以下几个:这药吃了就不能中断;对于副作用的忧虑;害怕这药用得过早,一旦耐药以后就没办法了;经济原因。如果还有别的治疗方案,可以暂时不去考虑易瑞沙,如果已经没什么办法了,先去多了解一些多咨询一些易瑞沙,不要轻易放弃。

    因为以上四点对于没有选择的末期病人来说是没有回旋余地的。这话说得可能有点残酷,但却是我们不得不面对的事实。

    在易瑞沙耐药之后,再次服用易瑞沙基本上是无效的,就目前搜集的资料看,进入视野的只有TARCEVA(它塞瓦,也即厄洛替尼)、ALIMTA(力比泰)以及因人而异的有效率很低再次化疗,但行至癌症末期,哪怕一点点可能性,对于家属来说都是要全力争取的希望所在。

    易瑞沙的副作用和耐药性。

    易瑞沙的说明书里详细的罗列了很多可能出现的副作用,但真正会出现的副作用都是很常见能够耐受的副作用,比如腹泻,皮肤搔痒等,比较严重的间质性肺炎的发生概率比较小;而耐药性的出现是不可控制,同时是因人而异的,到目前为止我所知道的服用易瑞沙时间最长的病人已经服用了2年多仍然没有耐药,所以易瑞沙一旦有效,对于末期癌症病人和家属来说是一个福音。但是耐药之后是很麻烦的,因为目前为止没有一个标准的耐药后治疗方案,当下主要的几种方案都是在摸索。

    服用易瑞沙的用药时间不明确,因为说明书上写得就很含糊,说是可以空腹或者与食物同服,我当时综合了很多服用易瑞沙病友的实际经验,制定了一个比较合理的服用时间——早饭后两小时,午饭前两小时服用,期间不进食,保证空腹状态。

以上言论皆为个人自行总结,具体情况因人而异,以上信息仅供参考。

==== 汉译英 ====

     Iressa reading the instructions, as well as summing up, after suffering from the use of the faithful, some individuals on the use of Iressa (IRESSA) view summarized in the following points, in the hope is being used or prepared to use the friends that recommended that:

1, Iressa in combination with chemotherapy did not improve the therapeutic effect, which is we all know, but here it refers to the chemotherapy drugs, including platinum drugs, but not in combination with vinorelbine, long-term service will increase with the Changchun Navelbine induced neutrophil less effect;

2, Iressa can be dissolved in water taking;

3, with clothes and food does not affect the absorption of Iressa;

4, the most serious side effects: interstitial pneumonia, the probability of occurrence of 0.28% (usually presents with acute shortness of breath, accompanied by cough; low heat, breathing discomfort and arterial blood oxygen unsaturated);

5, Iressa affect the liver, liver function should be regularly checked. Liver transaminase in patients with mild to moderate wins takes caution.

     Any eye symptoms, and severe persistent diarrhea, nausea, vomiting, and anorexia should immediately seek medical treatment.

     Iressa is the original British AstraZeneca, we mentioned also the drug gefitinib, Iressa is a targeted cancer therapy, usually one after the second-line standard chemotherapy is invalid third-line drugs, initial patients taking Iressa, if economic conditions permit, the best English version of the first trial, taking 6 months to apply for charitable gifts drug.

      If the economic conditions can be India's Iressa trial, efficacy was similar, but much cheaper.

     Iressa for cancer, non-smoking female patients, the efficacy of this type is superior to the non-, but not absolute, some patients have many years of smoking history of the men, the intake is also effective, while the conditions are met, the women to eat of no avail.

     But in my own shallow opinion, if the patient did not receive standard treatment, or staging is better, or should the standard therapy first, after all, Iressa is the final step is not an option approach. And taking the time to grasp the IRESSA is also very important, there are other treatment options may choose to take the time early is not good, because it can not be broken Yao Chi; and when the patient a second-tier programs are ineffective, very bad physical condition time, we can not hesitate.

     In fact, patients have hesitated because no more than the following: This is Yao Chi can not be interrupted; concerns about side effects; afraid of this medicine too soon, once the resistance of no other way to the future; economic reasons. If there are other treatment options, you can temporarily do not consider Iressa, if you have nothing to do, and first went to learn more about some of Iressa some more advice, do not give up easily.

     For the above four points for terminally ill patients who have no choice is no room for maneuver. This point was probably a bit cruel, but we have to face facts.

     In the Iressa drug resistance again after taking Iressa is basically null and void, on the current data collected to see into the field of vision only TARCEVA (it Ceva, that Erlotinib), ALIMTA (Alimta) as well as the efficiency is very low again, individualized chemotherapy, but the line to terminal cancer, even a little bit of possibilities, for the family member who has been to secure the hope for.

     Iressa side-effects and drug resistance.

     Iressa in detail the specification of the list a number of possible side effects, but there would potentially be a very common side effects are able to tolerate the side effects, such as diarrhea, skin itching and so on, the more serious probability of occurrence of interstitial pneumonia is relatively small; and the emergence of drug resistance can not control, is also vary, and so far I know the longest taking Iressa patient had gone to the intake of two years is still no resistance, so easy to Sweden sand, once effective, for terminal cancer patients and their families is an evangelical. However, after resistance is very troublesome, because so far there is no standard treatment programs after resistance, the moment of several major programs are being learned.

     Taking the drug Iressa time is not clear, because it is written is very vague on the instructions that can be an empty stomach or with food the same clothes, I had a lot of taking a comprehensive Iressa patient's own practical experience, has developed a more reasonable taking the time - two hours after breakfast, lunch, two hours before taking a period not eating, fasting state guarantee.

Jie Wei individuals on their own views in the above summary of the specific circumstances vary, the above information for reference only.

Tags: 易瑞沙使用总结

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更新日期: 2009-10-27 08:46
作者: : mcyclub
修订: 1.0

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