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多西他赛单药治疗高度预处理的转移性乳腺癌:一项基于社区的多中心可行性试验。

Docetaxel monotherapy in heavily pretreated metastatic breast cancer: a multicenter, community-based feasibility trial.

作者信息

Schmidinger M, Budinsky A C, Wenzel C, Locker G J, Pluschnig U, Brodowicz T, Kubista E, Maca S, Zabernigg A, Ilsinger P, Seewann L, Hojas S, Blach M, Zielinski C C, Steger G G

机构信息

Department of Medicine I, University Hospital of Vienna, Austria.

出版信息

Cancer Chemother Pharmacol. 2001;47(1):57-62. doi: 10.1007/s002800000204.

Abstract

PURPOSE

To evaluate the efficacy and safety of docetaxel in heavily pretreated and anthracycline-resistant patients with metastatic breast cancer in an outpatient setting.

PATIENTS AND METHODS

Between February 1996 and June 1998, 98 consecutive patients who had progressed during or relapsed following prior anthracycline-containing chemotherapy were enrolled into the trial. Docetaxel was administered at a dose of 100 mg/m2 by intravenous infusion every 3 weeks. The administration of colony-stimulating factors was at the discretion of the attending physician. Premedication with dexamethasone was mandatory for all patients.

RESULTS

Of the 98 patients, 93 were evaluable for toxicity and response. Patients had received two palliative regimens (median, range 1-5) prior to docetaxel treatment. The most frequent toxicity observed was leukopenia grade III and IV (WHO grading system) which occurred in 47% of patients (grade IV only in 14%). Except for alopecia grade III (64% of patients), nonhematologic side effects grade III-IV were rare (1-7% of patients) and included nausea, stomatitis, diarrhea, peripheral neuropathy, fluid retention and pulmonary toxicities. There were no treatment-related deaths. Objective responses occurred in 40% of patients (CR 6%, PR 34%), and stable disease in 38% of patients. The median duration of response was 5.3 months (range 0.7-18.1 months) while the median survival was 15 months (range 2 36 months).

CONCLUSION

Docetaxel is a highly active agent in patients with anthracycline-resistant metastatic breast cancer, even in heavily pretreated patients, with moderate toxicity.

摘要

目的

评估多西他赛在门诊环境中对接受过大量预处理且对蒽环类药物耐药的转移性乳腺癌患者的疗效和安全性。

患者与方法

1996年2月至1998年6月期间,98例在含蒽环类药物的先前化疗期间病情进展或复发的连续患者被纳入该试验。多西他赛以100mg/m²的剂量每3周静脉输注给药。集落刺激因子的使用由主治医师决定。所有患者均必须用地塞米松进行预处理。

结果

98例患者中,93例可评估毒性和反应。患者在接受多西他赛治疗前接受过两种姑息治疗方案(中位数,范围1 - 5)。观察到的最常见毒性是Ⅲ级和Ⅳ级白细胞减少(WHO分级系统),发生在47%的患者中(仅Ⅳ级为14%)。除Ⅲ级脱发(64%的患者)外,Ⅲ - Ⅳ级非血液学副作用很少见(1 - 7%的患者),包括恶心、口腔炎、腹泻、周围神经病变、液体潴留和肺部毒性。无治疗相关死亡。40%的患者出现客观缓解(完全缓解6%,部分缓解34%),38%的患者病情稳定。中位缓解持续时间为5.3个月(范围0.7 - 18.1个月),而中位生存期为15个月(范围2 - 36个月)。

结论

多西他赛对蒽环类药物耐药的转移性乳腺癌患者是一种高效的药物,即使是在接受过大量预处理的患者中,且毒性中等。

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