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多中心II期试验:每周使用紫杉醇治疗晚期或转移性乳腺癌——埼玉乳腺癌临床研究组(SBCCSG - 01)

Multicenter phase II trial of weekly paclitaxel for advanced or metastatic breast cancer: the Saitama Breast Cancer Clinical Study Group (SBCCSG-01).

作者信息

Sato Kazuhiko, Inoue Kenichi, Saito Tsuyoshi, Kai Toshihiro, Mihara Hiroyoshi, Okubo Katsuhiko, Koh Junichi, Mochizuki Hidetaka, Tabei Toshio

机构信息

Department of Surgery I, National Defense Medical College, Tokorozawa, Saitama, Japan.

出版信息

Jpn J Clin Oncol. 2003 Aug;33(8):371-6. doi: 10.1093/jjco/hyg075.

Abstract

OBJECTIVE

Weekly dosing of paclitaxel has been demonstrated to be a well-tolerated, feasible and effective administration schedule. In this study, we evaluated the efficacy and safety of weekly paclitaxel in Japanese women with advanced or metastatic breast cancer.

METHODS

Seventy-four patients were enrolled in the study. Paclitaxel was administered by 1 h intravenous infusion at a dose of 80 mg/m2 every week. Administration was continued for 3 weeks followed by a 1 week rest. A short premedication, consisting of dexamethasone 10 mg, ranitidine 50 mg and diphenylhydramine 50 mg, was given prior to each dose of paclitaxel. Eligibility criteria included an Eastern Cooperative Oncology Group performance status of 0, 1 or 2 and adequate hematological, hepatic and renal function.

RESULTS

Of 74 patients treated and evaluable for toxicities, 70 were evaluable for response. The mean age was 57.7 years. Forty-nine patients (66.2%) had received prior anthracyclines for metastatic diseases. The overall response rate among 74 patients was 40.5%, including 4.1% complete responses and 36.5% partial responses. The median follow-up time was 481 days (range, 24-903 days). The median time to progression was 4.8 months and median overall survival was 15.8 months. The majority of patients tolerated the treatment very well. Although alopecia was observed in most of the patients (93.2%), grade 3 or 4 neutropenia was 10.8% and grade 2 or 3 peripheral neuropathy was 13.5%.

CONCLUSION

Weekly paclitaxel as a 1 h infusion was active and generally well tolerated in previously treated patients. Further study of weekly paclitaxel in combination therapy is warranted.

摘要

目的

已证明紫杉醇每周给药是一种耐受性良好、可行且有效的给药方案。在本研究中,我们评估了每周一次紫杉醇对日本晚期或转移性乳腺癌女性患者的疗效和安全性。

方法

74例患者纳入本研究。紫杉醇通过静脉输注1小时给药,剂量为80mg/m²,每周一次。给药持续3周,随后休息1周。每次紫杉醇给药前给予由10mg地塞米松、50mg雷尼替丁和50mg苯海拉明组成的短程预处理。入选标准包括东部肿瘤协作组体能状态为0、1或2,以及血液学、肝脏和肾脏功能良好。

结果

在74例接受治疗并可评估毒性的患者中,70例可评估疗效。平均年龄为57.7岁。49例患者(66.2%)曾接受过蒽环类药物治疗转移性疾病。74例患者的总缓解率为40.5%,包括4.1%的完全缓解和36.5%的部分缓解。中位随访时间为481天(范围24 - 903天)。中位疾病进展时间为4.8个月,中位总生存期为15.8个月。大多数患者对治疗耐受性良好。虽然大多数患者(93.2%)出现脱发,但3或4级中性粒细胞减少症为10.8%,2或3级周围神经病变为13.5%。

结论

每周一次1小时输注的紫杉醇在既往接受过治疗的患者中具有活性且总体耐受性良好。有必要进一步研究每周一次紫杉醇用于联合治疗。

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