Kim Ryungsa, Osaki Akihiko, Toge Tetsuya
Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Japan.
Oncol Rep. 2003 Jan-Feb;10(1):145-50.
The therapeutic efficacy of weekly paclitaxel infusion for relapsed breast cancer patients is not known. We assessed safety, feasibility, and therapeutic efficacy in a pilot study of weekly 1-h low-dose paclitaxel infusion for relapsed breast cancer in an outpatient clinic. Eighteen patients with relapsed breast cancer who had received prior chemotherapy regimens, including anthracyclines, mitomycin, and 5-fluorouracil beyond a second line of treatment were enrolled into the study. The dose of paclitaxel was between 40 mg/m(2) and 80 mg/m(2) per week in a 1-h infusion, and a treatment cycle was 4 weeks until there was no evidence of progressive disease. When a dose of 80 mg/m(2) was administered, the treatment cycle was weekly infusion three times with a 1-week interval per 4-week cycle. The mean treatment period was 5.5 months and the maximal length of administration was 8 months. The overall response rate was 44.4%, including 2 cases of complete response and 6 cases of partial response. Tumor response was observed in 3 of 7 cases of lung metastases (42.8%), 6 of 12 cases of soft tissue metastases (50.0%), and 1 of 3 cases of liver metastases (33.3%), whereas 8 cases with bone metastases did not respond. The mean time to response was 1.8 months and the mean response duration was 4.3 months. The dose between 31.5 mg/m(2)/wk and 79.7 mg/m(2)/wk was not associated with tumor response. Toxicities associated with weekly 1-h low-dose paclitaxel infusion were tolerable, and most were less than grade 2, including alopecia (100%), neutropenia (88.8%), flushing (66.6%), face edema (61.1%), numbness (55.5%), and myalgia (38.8%). There was 1 case of grade 3 neutropenia. Weekly 1-h low-dose paclitaxel might be a therapeutically effective, safe infusion and feasible as a salvage chemotherapy for relapsed breast cancer patients following failure of prior chemotherapy.
每周一次紫杉醇输注对复发乳腺癌患者的治疗效果尚不清楚。我们在一项门诊试点研究中评估了每周1小时低剂量紫杉醇输注治疗复发乳腺癌的安全性、可行性和治疗效果。18例接受过包括蒽环类、丝裂霉素和5-氟尿嘧啶等二线以上化疗方案的复发乳腺癌患者被纳入研究。紫杉醇剂量为每周40mg/m²至80mg/m²，静脉输注1小时，治疗周期为4周，直至无疾病进展证据。当给予80mg/m²剂量时，治疗周期为每4周每周输注3次，每次间隔1周。平均治疗期为5.5个月，最长给药时间为8个月。总缓解率为44.4%，包括2例完全缓解和6例部分缓解。7例肺转移患者中有3例（42.8%）出现肿瘤缓解，12例软组织转移患者中有6例（50.0%）出现肿瘤缓解，3例肝转移患者中有1例（33.3%）出现肿瘤缓解，而8例骨转移患者无反应。平均缓解时间为1.8个月，平均缓解持续时间为4.3个月。31.5mg/m²/周至79.7mg/m²/周的剂量与肿瘤缓解无关每周1小时低剂量紫杉醇输注相关的毒性是可耐受的，大多数毒性低于2级，包括脱发（100%）、中性粒细胞减少（88.8%）、潮红（66.6%）、面部水肿（61.1%）麻木（55.%)和肌痛（38.8%）。有1例3级中性粒细胞减少。每周1小时低剂量紫杉醇可能是一种治疗有效的、安全的输注方式，作为先前化疗失败后复发乳腺癌患者的挽救化疗是可行的。
