关键词: 吉非替尼, 厄洛替尼, 间质性肺病

Abstract: Objective To explore the clinical characteristics of interstitial lung disease (ILD) induced by gefitinib and erlotinib. Methods The reports of ILD induced by gefitinib and erlotinib from January 2004 to December 2016 were collected and analyzed from Web of Science and Wanfang databases. Results A total of forty-six patients were entered. Forty-five patients were diagnosed as non-small cell lung cancer and one patient was diagnosed as pancreatic cancer. Several patients has a history of radioactive pneumonia, interstitial lung lesion or chronic bronchitis. Gefitinib was given 250 mg/d in twenty-four patients (52.17%) and erlotinib was given 150 mg/d in twenty-two patients (47.83%). The ILD occurred during two to seven hundred and thirty days after medication, and 57.78% of ILD occurred during the first month after medication. The major clinical manifestations of ILD were dyspnea, cough and fever. Ground glass opacity, patchy consolidation or reticular opacity were found during chest X-ray or CT examination. The patients who were diagnosed as ILD were withdrawn immediately and forty-three patients were treated with symptomatic steroids such as dexamethasone, meprednisone and prednisone. Twenty-four patients’ symptoms and imaging features improved. Twenty patients died, and fourteen patients died during the first month after the diagnosis of ILD. Conclusion Gefitinib or erlotinib induced ILD is an acute and fatal complication. Respiratory symptoms should be monitored carefully after medication and high resolution CT is essential for diagnosis of ILD. Once the diagnosis of ILD is con?rmed, management includes discontinuation of EGFR-TKI, administration of steroids and provision of supportive care including antibacterial agents if appropriate.

Key words: gefitinib, erlotinib, interstitial lung disease