Le Chevalier T, Bérille J, Zalcberg J R, Millward M J, Monnier A, Douillard J Y, McKeage M J, James R, Soulas F, Loret C, Bougon N, Bizzari J P
Department of Medicine, Institut Gustave-Roussy, Villejuif, France.
Semin Oncol. 1999 Jun;26(3 Suppl 11):13-8.
Cisplatin-based chemotherapy is effective in non-small cell lung cancer (NSCLC), although it prolongs survival only modestly. Single-agent docetaxel (Taxotere; Rhône-Poulenc Rorer, Antony, France) is highly active against NSCLC. The activity and tolerability of two docetaxel/ cisplatin regimens were therefore investigated in two multicenter phase II studies, one in Australia and one in France. Chemotherapy-naive patients with inoperable NSCLC received either docetaxel 75 mg/m2 on day 1 plus cisplatin 75 mg/m2 3 weekly (n = 47; Australian study) or docetaxel 75 mg/m2 on day 1 plus cisplatin 100 mg/m2 every 3 weeks for three cycles then every 6 weeks (n = 51; French study). The majority of the population (74%) had metastatic disease. Seventy-eight patients were evaluable for efficacy. Overall response rates were 36% (95% confidence interval, 25 to 47) in all evaluable patients and 34% in patients with metastases. Median duration of response was 6 months, with a 4-month median time to progression. Median survival time was 9 months, with a 1-year survival rate of 34%. A median of four (range, one to nine) treatment cycles were administered. Febrile neutropenia occurred in 14% of patients. Severe infection, which occurred in less than 7% of patients, led to two toxic deaths. Other severe toxicities were rare, with severe stomatitis and severe neurosensory side effects reported in 2% and 1%, respectively, of treated patients. No severe fluid retention occurred. Docetaxel/cisplatin, administered as two different schedules, is well tolerated and exhibits efficacy in the range of the most established combinations in the treatment of advanced NSCLC.
基于顺铂的化疗对非小细胞肺癌(NSCLC)有效,尽管其仅适度延长生存期。单药多西他赛(泰索帝;法国罗纳普朗克乐安公司,安东尼市)对NSCLC具有高度活性。因此,在两项多中心II期研究中调查了两种多西他赛/顺铂方案的活性和耐受性,一项在澳大利亚进行,另一项在法国进行。未经化疗的无法手术的NSCLC患者接受以下两种方案之一:第1天给予多西他赛75mg/m²加顺铂75mg/m²,每3周一次(n = 47;澳大利亚研究);或第1天给予多西他赛75mg/m²加顺铂100mg/m²,每3周一次,共三个周期,然后每6周一次(n = 51;法国研究)。大多数患者(74%)患有转移性疾病。78例患者可评估疗效。所有可评估患者的总体缓解率为36%(95%置信区间,25%至47%),转移性患者为34%。中位缓解持续时间为6个月,则中位疾病进展时间为4个月。中位生存时间为9个月,1年生存率为34%。中位给予四个(范围为1至9个)治疗周期。14%的患者发生发热性中性粒细胞减少。严重感染发生率低于7%,导致2例毒性死亡。其他严重毒性罕见,治疗患者中分别有2%和1%报告发生严重口腔炎和严重神经感觉副作用。未发生严重液体潴留。以两种不同方案给药的多西他赛/顺铂耐受性良好,在晚期NSCLC治疗中显示出与最常用联合方案相当的疗效。