Muro K, Hamaguchi T, Ohtsu A, Boku N, Chin K, Hyodo I, Fujita H, Takiyama W, Ohtsu T
Division of Gastrointestinal Oncology, National Cancer Center Hospital, Tokyo, Japan.
Ann Oncol. 2004 Jun;15(6):955-9. doi: 10.1093/annonc/mdh231.
To evaluate the activity and toxicity of docetaxel in patients with metastatic esophageal cancer.
Eligible patients had histologically confirmed carcinoma of the esophagus with measurable metastatic sites according to Response Evaluation Criteria in Solid Tumors (RECIST). Patients were either chemotherapy-naïve or previously treated with one regimen of chemotherapy. Docetaxel 70 mg/m(2) was administered intravenously over 1-2 h, every 21 days.
Of 52 patients enrolled in this study, three were excluded because they did not receive docetaxel due to worsening condition after enrollment. Thirty-six patients had received prior platinum-based chemotherapy. The majority of patients (94%) had squamous cell carcinoma. Ten of 49 evaluable patients [20%; 95% confidence interval (CI) 10-34%] showed a partial response. Of the 10 partial responses, six patients had received prior platinum-based chemotherapy. Grade 3 or 4 neutropenia was noted in 43 of 49 patients (88%), and nine of 49 patients (18%) developed febrile neutropenia. Twenty-eight of 49 patients (57%) required lenograstim. Grade 3 anorexia and fatigue occurred in nine (18%) and six (12%) patients, respectively. Median survival time was 8.1 months (95% CI 6.6-11.3) and the 1-year survival rate was 35% (95% CI 21-48%).
Docetaxel as a single agent is effective in esophageal cancer, but careful management of neutropenia is needed.
评估多西他赛在转移性食管癌患者中的活性和毒性。
符合条件的患者经组织学确诊为食管癌,根据实体瘤疗效评价标准(RECIST)有可测量的转移部位。患者既往未接受过化疗或曾接受过一种化疗方案。多西他赛70mg/m²静脉滴注1 - 2小时,每21天一次。
本研究纳入的52例患者中,3例因入组后病情恶化未接受多西他赛治疗而被排除。36例患者曾接受过铂类为基础的化疗。大多数患者(94%)为鳞状细胞癌。49例可评估患者中有10例(20%;95%置信区间[CI] 10 - 34%)显示部分缓解。在这10例部分缓解患者中,6例曾接受过铂类为基础的化疗。49例患者中有43例(88%)出现3级或4级中性粒细胞减少,49例患者中有9例(18%)发生发热性中性粒细胞减少。49例患者中有28例(57%)需要使用来格司亭。9例(18%)和6例(12%)患者分别出现3级厌食和疲劳。中位生存时间为8.1个月(95% CI 6.6 - 11.3),1年生存率为35%(95% CI 21 - 48%)。
多西他赛单药治疗食管癌有效,但需要谨慎处理中性粒细胞减少问题。