Ichinose Yukito, Nakai Yushi, Kudoh Shoji, Semba Hiroshi, Yoshida Susumu, Nukiwa Toshihiro, Yamamoto Hidehiko, Yamane Yoshio, Niitani Hisanobu
Department of Thoracic Oncology, National Kyusyu Cancer Center, Fukuoka, Japan.
Clin Cancer Res. 2004 Jul 1;10(13):4369-73. doi: 10.1158/1078-0432.CCR-04-0143.
To evaluate the efficacy and toxicity of a novel combination treatment using concurrent radiotherapy with cisplatin plus UFT, which is comprised of uracil and tegafur, in locally advanced non-small cell lung cancer (NSCLC) patients.
In this Phase II trial, patients with unresectable stage III NSCLC were treated with the oral administration of UFT (400 mg/m(2)/d tegafur) on days 1-14 and days 29-42 whereas 80 mg/m(2) cisplatin was administered i.v. on days 8 and 36. Radiotherapy, with a total dose of 60 Gy, was delivered in 30 fractions from day 1.
Seventy patients were enrolled and eligible, as follows: 57 males/13 females; mean age 61 ranging from 36 to 74; performance status 0/1:45/25; stage IIIA/IIIB, 14/56. A complete response was observed in two patients and a partial response in 54 patients, and the overall response rate was 81% (95% confidence interval; 70-89%). The median survival, the 1- and 2-year survival rates were 16.5 months, 67% and 33%, respectively. Grade 3/4 leukopenia occurred in 14%/1% of the patients. Grades 3 non-hematological toxicities were only reported in three patients with nausea, two with esophagitis and one with pneumonitis whereas no grade 4 non-hematological toxicity was observed.
UFT plus cisplatin with concurrent radiotherapy is considered to be a feasible and effective treatment for locally advanced NSCLC patients. Additional study of this concurrent chemoradiotherapy is warranted.
评估顺铂联合由尿嘧啶和替加氟组成的优福定(UFT)同步放疗这种新型联合治疗方案对局部晚期非小细胞肺癌(NSCLC)患者的疗效和毒性。
在这项II期试验中,不可切除的III期NSCLC患者在第1 - 14天和第29 - 42天口服优福定(替加氟400 mg/m²/天),而在第8天和第36天静脉注射80 mg/m²顺铂。从第1天开始进行放疗,总剂量60 Gy,分30次给予。
70例患者入组且符合条件,具体如下:男性57例/女性13例;平均年龄61岁,范围为36至74岁;体能状态0/1:45/25;IIIA/IIIB期,14/56例。2例患者观察到完全缓解,54例患者部分缓解,总缓解率为81%(95%置信区间;70 - 89%)。中位生存期、1年和2年生存率分别为16.5个月、67%和33%。14%/1%的患者发生3/4级白细胞减少。仅3例患者报告有3级非血液学毒性,其中恶心2例、食管炎1例,肺炎1例,未观察到4级非血液学毒性。
优福定联合顺铂同步放疗被认为是局部晚期NSCLC患者一种可行且有效的治疗方法。有必要对这种同步放化疗进行进一步研究。