細支氣管肺泡肺癌是肺癌的一種，在末期常以由支氣管擴散以及支氣管漏(bronchorrhea)來表現。細支氣管肺泡肺癌末期患者對傳統化學治療反應差而且預後差。Gefinitib("Iressa")是一種口服、具活性、具選擇性之上皮生長因子受體酥胺酸(tyrosine)激酶抑制劑，可以阻斷癌細胞增殖以及存活的訊號傳遞路徑。我們在此報告一84歲男性，臨床上以右下肺葉浸潤，抗生素使用無效而併呼吸衰竭，經支氣管鏡肺生檢確診為細支氣管肺泡肺癌，後以Gefitinib合併其他治療的經驗。我們給予的治療，明顯地減少漿液狀痰液的量以及使患者在治療一週之後成功地脫離呼吸器。文獻上有研究顯示細支氣管肺泡肺癌從未吸菸者是對此藥有反應獨立因子，我們經此例經驗推論：戒菸超過20年以上併有複合乳突狀結構之細支氣管肺泡肺泡患者，亦適於以Gefitinib治療，而勿放棄有可能改善的機會。另外，此一治療方法對於老年人以及併有嚴重內科疾病患者特別合適。

Bronchioloalveolar carcinoma (BAC) is a form of pulmonary adenocarcinoma that presents endobronchial spread and bronchorrhea in advanced stages. The prognosis for BAC patients in advanced stages is poor because of poor response to conventional chemotherapy. Gefitinib ("Iressa") is an orally active, selective epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (EGFR-TKI) that blocks signal transduction pathways implicated in the proliferation and survival of cancer cells. In this paper, we report on our experience treating with Gefitinib and other life saving measures an 84-year-old man with BAC of RLL and impending respiratory failure. Our selected treatment dramatically reduced the production of serous sputum and the patient was successfully liberated from mechanical ventilation within one week of the onset of treatment. We postulate that ex-smoker who have already quit for an extended period of time (>20 years) and display a complex papillary structure of bronchioloalveolar carcinoma in the lungs might be suitable candidates for treatment with Gefitinib. Furthermore, this treatment may even be particularly suited for difficult patient subgroups such as the elderly and those with existing serious medical conditions.