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一项针对广泛期小细胞肺癌患者的II期研究结果,这些患者的东部肿瘤协作组体能状态为2,或年龄≥70岁,治疗方案为每周一次紫杉醇联合卡铂。

Results of a phase II study of weekly paclitaxel plus carboplatin in patients with extensive small-cell lung cancer with Eastern Cooperative Oncology Group Performance Status of 2, or age > or = 70 years.

作者信息

Neubauer Marcus, Schwartz Jonathan, Caracandas John, Conkling Paul, Ilegbodu Des, Tuttle Troy, Asmar Lina

机构信息

Kansas City Cancer Center, Overland Park, KS 66210, USA.

出版信息

J Clin Oncol. 2004 May 15;22(10):1872-7. doi: 10.1200/JCO.2004.11.023.

Abstract

PURPOSE

To determine the 1-year survival, response rate (RR), time to progression (TTP), and safety of weekly paclitaxel plus carboplatin (PC) in patients with extensive small-cell lung cancer (ESCLC) with an Eastern Cooperative Performance Status performance status (PS) of 2 or an age > or = 70 years.

PATIENTS AND METHODS

Patients were treated with PC (paclitaxel 80 mg/m(2) and carboplatin area under the curve = 2) by intravenous infusion on days 1, 8, and 15 of every 4-week cycle for up to six cycles.

RESULTS

Between July 2000 and December 2001, 77 eligible patients (50.6% were male, 97.4% were white, 44.2% had PS of 2, with median age of 74 years) with ESCLC were enrolled. Among the 66 patients who were assessable for response, 25 responded to treatment (one complete response and 24 partial responses), for an objective RR of 38%. There were eight cases of stable disease (12.1%) and 33 cases of progressive disease (50%). The median survival was 7.2 months (range, < 1 to 24.4 months), and the estimated 1-year survival rate was 30%. The median TTP was 3.5 months (range, < 1 to 21.2 months), and the estimated 1-year progression-free survival rate was 8%. The median duration of response was 4.5 months (range, 1.6 to 17.5 months). One death (sepsis) was possibly related to the study drugs. Grades 3 and 4 toxicities experienced by > or = 5% of patients included neutropenia (22.1%), fatigue (8.6%), anemia (5.2%), and nausea/vomiting (5.2%).

CONCLUSION

This regimen produced relatively few toxicities (only two of the 66 assessable patients received fewer than two cycles because of toxicity), and both the median and 1-year survival were similar to other regimens. This regimen may be a preferable treatment choice for patients with ESCLC who have a poor PS or who are aged > or = 70 years.

摘要

目的

确定对于东部肿瘤协作组(ECOG)体能状态(PS)为2或年龄≥70岁的广泛期小细胞肺癌(ESCLC)患者,每周紫杉醇联合卡铂(PC)方案的1年生存率、缓解率(RR)、疾病进展时间(TTP)及安全性。

患者与方法

患者接受PC方案(紫杉醇80mg/m²,卡铂曲线下面积=2)治疗,每4周为1个周期,在第1、8和15天静脉输注,最多6个周期。

结果

2000年7月至2001年12月,纳入77例符合条件的ESCLC患者(50.6%为男性,97.4%为白人,44.2%的PS为2,中位年龄74岁)。在66例可评估缓解情况的患者中,25例对治疗有反应(1例完全缓解,24例部分缓解),客观缓解率为38%。有8例疾病稳定(12.1%),33例疾病进展(50%)。中位生存期为7.2个月(范围:<1至24.4个月),估计1年生存率为30%。中位TTP为3.5个月(范围:<1至21.2个月),估计1年无进展生存率为8%。中位缓解持续时间为4.5个月(范围:1.6至17.5个月)。1例死亡(败血症)可能与研究药物有关。≥5%的患者出现的3级和4级毒性包括中性粒细胞减少(22.1%)、疲劳(8.6%)、贫血(5.2%)和恶心/呕吐(5.2%)。

结论

该方案产生的毒性相对较少(66例可评估患者中仅2例因毒性接受少于2个周期的治疗),中位生存期和1年生存率与其他方案相似。对于PS较差或年龄≥70岁的ESCLC患者,该方案可能是更合适的治疗选择。

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