Sakai Hiroshi, Yoneda Shuichi, Kobayashi Kunihiko, Komagata Hiroshi, Kosaihira Seiji, Kazumoto Tomoko, Saito Yoshihiro
Division of Respiratory Disease, Saitama Cancer Center, 818 Komuro, Ina, Saitama, 362-0806, Japan.
Lung Cancer. 2004 Feb;43(2):195-201. doi: 10.1016/j.lungcan.2003.08.021.
Docetaxel and carboplatin (DC) have demonstrated activity as radiation sensitizers in pre-clinical studies. The aim of this phase II study was to evaluate the efficacy and toxicity of DC with concurrent thoracic radiation therapy (TRT) followed by consolidation chemotherapy with DC for stage III unresectable non-small cell lung cancer (NSCLC).
Thirty-three previously untreated patients with inoperable, locally advanced (LA) NSCLC received docetaxel 30 mg/m2 over 1 h and carboplatin at an AUC of 3 every 2 weeks for six courses--four courses during concurrent chemoradiotherapy and two courses following completion of radiotherapy. Concurrent TRT was performed in 2-Gy daily fractions to a total dose of 60 Gy.
Among 32 evaluable patients, the overall response rate was 91%, with two complete responses (CR) and 27 partial responses (PR). Median survival time by intention-to-treat analysis was 27 months, with survival rates of 76% at 1 year and 61% at 2 years. Serious side effects were generally limited to grade 3 neutropenia in 6%, grades 3 and 4 pulmonary toxicity in 6 and 3%, respectively, and grade 3 esophagitis in 3% of patients.
DC with concurrent TRT followed by consolidation chemotherapy was highly active with manageable toxicity in patients with stage III unresectable NSCLC.
在临床前研究中,多西他赛和卡铂(DC)已显示出作为放射增敏剂的活性。本II期研究的目的是评估DC同步胸部放疗(TRT),随后用DC进行巩固化疗治疗III期不可切除非小细胞肺癌(NSCLC)的疗效和毒性。
33例既往未接受过治疗的无法手术的局部晚期(LA)NSCLC患者,每2周接受1小时静脉滴注多西他赛30mg/m²及卡铂AUC为3,共6个疗程——同步放化疗期间4个疗程,放疗结束后2个疗程。同步TRT采用每日2Gy分次照射,总剂量60Gy。
32例可评估患者中,总缓解率为91%,其中2例完全缓解(CR),27例部分缓解(PR)。意向性分析的中位生存时间为27个月,1年生存率为76%,2年生存率为61%。严重副作用一般仅限于6%的3级中性粒细胞减少、6%的3级和3%的4级肺部毒性以及3%的患者出现3级食管炎。
对于III期不可切除NSCLC患者,DC同步TRT后巩固化疗具有高活性且毒性可控。