老马哥新年快乐！昨天一口气看完你的帖子，受益非浅，现在有问题想向你请教一下。我爸11年4月份查出的肺鳞癌，也是中心型无法手术，用GP方案化疗6次，放21次，然后一直空窗了9个月，现在想想那时太笨了，不知道上网查查资料，那么宝贵的时间都浪费了。12年8月20日复查，肿瘤复发了，9月8号在另一家医院做化疗，还是用的GP方案，加大了药量，但没有化完，各方面都低，9月26号出院在家修养，11月12号复查胸膜转移，腹部，肝和肾上都有，12月20号复查大致同前，骨头有两处出现异常，应该是骨转了吧，我爸每天都很痛，无法休息，吃的也非常少，两个月很少下床，走路喘，胀气严重。29号开始吃特，吃后觉得的全身发热，疼痛感消失，也能吃点饭了，今天第6天吃药，期间虽偶尔会痛会，但好多了，不知特是有效还是无效。现在想问您如果特无效我们下一步首选用什么靶向药，吃特时是否还要专门做针对骨转的治疗。如果化疗用什么药好，憨叔说用力比泰，但我在你这看到说力比泰容易出血，我爸偶尔会咳出粉红色的东西，不知道是什么，所以想听听你的建议。谢谢。
老马家2992的效果真不错，减量和间隔用法拉长了极限效果到来时间，相当于延长了生存时间。
飘逸A 发表于 2013-1-3 09:26 static/image/common/back.gif
老马哥新年快乐！昨天一口气看完你的帖子，受益非浅，现在有问题想向你请教一下。我爸11年4月份查出的肺鳞癌 ...
谢谢老马哥，我爸吃特觉得鼻子特别干怎么解决，骨转针的名字叫什么，一般药店有吗？
老马老师：妈妈肺癌骨转后，正在培美+卡铂化疗。医院给吃了甲地孕酮的药，好象胃口特别好，我记得好象您说过此药不能吃过一周，对吗？还有，这几天妈妈突然晚上口干得很，需要喝很多水，是化疗的事还是别的原因呢？谢谢！
飘逸A 发表于 2013-1-5 18:34 static/image/common/back.gif
谢谢老马哥，我爸吃特觉得鼻子特别干怎么解决，骨转针的名字叫什么，一般药店有吗？
鼻子干可以炖些鸭梨吃，或者蚝豉咸猪骨粥。
骨转针你要到医院去打。
感受生活 发表于 2013-1-6 11:05 static/image/common/back.gif
老马老师：妈妈肺癌骨转后，正在培美+卡铂化疗。医院给吃了甲地孕酮的药，好象胃口特别好，我记得好象您说过 ...
非常感谢老马老师
本帖最后由 棒海狸 于 2013-1-6 22:25 编辑
祝老马老师新年快乐！今天看了你的，《肺癌骨转移的双膦酸盐治疗》这篇文章，想有个问题请教你：我父亲由于手术前未确定病灶的良性还是恶性，所以先行手术，确定恶性后，手术后补做了骨扫描，结论：右侧股骨颈骨代谢增高灶，建议进一步检查。三个月后核磁复查：右侧髂骨、股骨头、股骨颈见结节状异常信号T1WI低信号、T2WI高信号。左侧股骨头见斑点状T2W1高信号影，髋臼及关节间隙如常，左侧髋关节囊见少量积液。结果诊断：右侧髂骨、股骨颈及两侧股骨头异常信号。问过好多医生，未能诊断是否骨转移。术后至今已7月多，一直未疼痛，碱性磷酸酶也正常，请问老师骨转移的可能性大吗？
我觉得骨转移可能性大，建议再做个核磁，看看有什么变化没有。
确定后可以打骨转针。
肿瘤指标有没有检查？
谢谢马老师这么快回复;肿瘤指标有检查,CEA手术前5.6,手术后2.7,总共四次培美曲塞+顺伯,前三次后CEA都在2.7左右,第四次后4.22,现在3.6,现在跟正常人一模一样,体重回升3公斤,正常上班,真想现在的好时光能长点,再长点.
LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
THERAPE UTIC PERSPECTIVES
J. Mazieres, S. Peters
Introduction: HER2 oncogene is a memb er of the EGFR family, encoding atransmembrane receptor that drives and regulates cell proliferation. HER2 mutations are identified in about 2% of non small cell lung cancer (NSCLC) , mainly located in exon 20, and appear to be critical for lung cancer carcinogenesis . Very scarce data are available to define a clinical profile of the patients harboring HER2 mutated NSCLC. We aimed to study clinic opatholog ical characteristics an d therapeutic
outcomes of patients harboring HER2 mutation in a large European series. Result s:We retrospec tively ide ntified 46 NSCLC patients diagn osed with HER2 exon 20 mut ation. HER2 mutation was mainly exclusive as only one concomitan t KRas mutation was des cribed. Our population was characterized by a median age of 60 yr (31 to 86 yr), a high proportion of women (30 vs. 16 men, 65% ), and of never smokers (24, 52%). All tumors were adenoc arcinomas (two with lepidic features). Half of the patients had stage IV dise ase at the time of diagnosis. HER2 targeted
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2
treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
disease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to
lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and
22.9 months for respectively early stage and stag e IV patients.
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,
reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
clinicaltrials.