Yamaguchi Kensei, Tada Masahiro, Horikoshi Noboru, Otani Toru, Takiuchi Hiroya, Saitoh Soh, Kanamaru Ryunosuke, Kasai Yasushi, Koizumi Wasaburo, Sakata Yuh, Taguchi Tetsuo
Department of Gastroenterology, Saitama Cancer Center Hospital, 818 Komuro, Ina-machi, Saitama 362-0806, Japan.
Gastric Cancer. 2002;5(2):90-5. doi: 10.1007/s101200200015.
To increase the options for agents for gastric cancer chemotherapy, we performed a phase II clinical trial on the use of a 3-h infusion of paclitaxel to confirm its efficacy and the feasibility of its use in patients with advanced gastric cancer.
Thirty-two (32) patients with measurable metastatic gastric cancer were enrolled in this study. Seventeen patients (53%) had received prior chemotherapy for metastatic disease, 4 patients (13%) had adjuvant chemotherapy alone, and 11 patients (34%) were chemotherapy-naive. Paclitaxel was intravenously infused for 3 h, at a dose of 210 mg/m(2), once every 3 weeks. To prevent hypersensitivity reactions, standard premedication was administered to all patients.
Nine (28%; 9/32 ) objective partial responses (PRs) were observed (95% confidence interval [CI], 14%-47%), and the remaining 23 patients showed stable (12 patients; 37.5%) and progressive disease (11 patients; 34.4%). The median time to response was 20 days (range, 14-38 days). The median response duration was 87 days (range, 50-103 days). The median survival of all patients was 234 days (range, 13-646+ days). The major adverse reactions were myelosuppression (grade 3/4 leukopenia and neutropenia were observed in 59% and 88% of the patients, respectively), alopecia, and peripheral neuropathy. Peripheral neuropathy was observed in 19 patients, however, most of the patients recovered after the completion of treatment.
A 3-h infusion of paclitaxel is an effective therapy for advanced gastric cancer and is clinically well tolerated by the patients.
为增加胃癌化疗药物的选择,我们进行了一项关于使用3小时静脉输注紫杉醇的II期临床试验,以确认其疗效及在晚期胃癌患者中使用的可行性。
32例可测量转移性胃癌患者纳入本研究。17例患者(53%)曾接受过转移性疾病的化疗,4例患者(13%)仅接受过辅助化疗,11例患者(34%)未接受过化疗。紫杉醇以210mg/m²的剂量静脉输注3小时,每3周一次。为预防过敏反应,所有患者均给予标准预处理。
观察到9例(28%;9/32)客观部分缓解(PR)(95%置信区间[CI],14%-47%),其余23例患者病情稳定(12例患者;37.5%)和进展(11例患者;34.4%)。中位缓解时间为20天(范围,14 - 38天)。中位缓解持续时间为87天(范围,50 - 103天)。所有患者的中位生存期为234天(范围,13 - 646 +天)。主要不良反应为骨髓抑制(分别在59%和88%的患者中观察到3/4级白细胞减少和中性粒细胞减少)、脱发和周围神经病变。19例患者出现周围神经病变,然而,大多数患者在治疗结束后恢复。
3小时静脉输注紫杉醇是晚期胃癌的有效治疗方法,患者临床耐受性良好。