The impact of rescue or maintenance therapy with EGFR TKIs for Stage IIIb-IV non-squamous non-small-cell lung cancer patients requiring mechanical ventilation
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- 作者：Te-Chun Hsia ; Chih-Yen Tu ; Hung-Jen Chen
- 关键词：Stage IIIb ; IV non ; squamous NSCLC ; Respiratory failure ; EGFR TKI ; SAPS II score ; SOFA score
- 刊名：BMC Anesthesiology
- 出版年：2014
- 出版时间：December 2014
- 年：2014
- 卷：14
- 期：1
- 全文大小：453 KB
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14. Mok, TS, Wu, YL, Thongprasert, S, Yang, CH, Chu, DT, Saijo, N, Sunpaweravong, P, Han, B, Margono, B, Ichinose, Y, Nishiwaki, Y, Ohe, Y, Yang, JJ, Chewaskulyong, B, Jia - 刊物主题：Anesthesiology; Internal Medicine; Emergency Medicine; Intensive / Critical Care Medicine;
- 出版者：BioMed Central
- ISSN：1471-2253
文摘
Background The toxicity of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) is less than that of cytotoxic agents. The reports of dramatic response and improvement in performance status with the use of EGFR TKIs may influence a physician’s decision-making for patients with non-squamous non-small cell lung cancer (NSCLC) and life-threatening respiratory distress. The aim of this study was to evaluate the outcome of rescue or maintenance therapy with EGFR TKI for stage IIIb-IV non-squamous NSCLC patients requiring mechanical ventilation. Methods Eighty-three Asian patients with stage IIIb-IV non-squamous NSCLC and who required mechanical ventilation between June 2005 and January 2010 were evaluated. Results Of the 83 patients, 16 (19%) were successfully weaned from the ventilator. The use of EGFR TKI as rescue or maintenance therapy during respiratory failure did not improve the rate of successful weaning (standard care 18% vs. with EGFR TKI, 22%; p--.81) in univariate and multivariate analyses. Conclusions Rescue or maintenance therapy with EGFR TKI for stage IIIb-IV non-squamous NSCLC patients requiring mechanical ventilation was not associated with better outcome. An end-of-life discussion should be an important aspect in the care of this group of patients, since only 19% were successfully weaned from mechanical ventilation.