作者：郭昭君，毕经旺

单位：

1.261053山东省潍坊市，潍坊医学院2.250031山东省济南市，中国人民解放军联勤保障部队第九六〇医院南院肿瘤科3.250000山东省济南市，山东省第二人民医院肿瘤科

Units：

1.Weifang Medical College, Weifang 261053, China2.Department of Oncology, the 960th Hospital of the People's Liberation Army, Jinan 250031, China3.Department of Oncology, Shandong Second People's Hospital, Jinan 250000, China

关键词：

肺肿瘤；肺癌；表皮生长因子受体基因；18外显子突变；病例报告

Keywords：

Lung neoplasms; Lung cancer; Epidermal growth factor receptor genes; Exon 18 mutation; Case reports

CLC：

R 734.2

DOI：

10.12114/j.issn.1008-5971.2023.00.232

Funds：

摘要：

表皮生长因子受体（EGFR）基因突变常见于19外显子突变和21外显子突变，占所有肺癌患者的80%～90%，而18外显子突变少见。本文报道1例EGFR 18外显子E709_ T710 delinsD突变的女性肺癌患者，其经化疗（培美曲塞+奈达铂+贝伐珠单抗）联合阿法替尼治疗后出现严重的腹泻及皮疹等毒副作用，之后将阿法替尼减量至隔日1次，患者耐受性良好，并顺利完成6周期化疗，院外坚持服用阿法替尼。化疗3个月后复查胸部CT显示病灶较前明显缩小，疗效评估为部分缓解。

Abstract：

Epidermal growth factor receptor (EGFR) gene mutations are common in exon 19 mutations and exon 21mutations, accounting for 80%-90% of all lung cancer patients, while exon 18 mutations are rare. This article reported a female lungcancer patient with EGFR exon 18 E709_T710 delinsD mutation. After the treatment with chemotherapy (pemetrexed+nedaplatin+bevacizumab) combined with afatinib, the patients developed severe side effects such as diarrhea and rash. After that, afatinibwas reduced to once every other day, and the patient was well tolerated and successfully completed 6 cycles of chemotherapy, andinsisted on taking afatinib outside the hospital. After 3 months of chemotherapy, chest CT showed that the lesion was significantlysmaller than before, and the efficacy was evaluated as partial remission.

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