Okamoto Isamu, Moriyama Eiji, Fujii Shinji, Kishi Hiroto, Nomura Masanobu, Goto Eisuke, Kiyofuji Chikage, Imamura Fumiya, Mori Takashi, Matsumoto Mitsuhiro
Department of Respiratory Medicine, Kumamoto University, Kumamoto, Japan.
Jpn J Clin Oncol. 2005 Apr;35(4):188-94. doi: 10.1093/jjco/hyi059.
More than 30% of cases of non-small cell lung cancer (NSCLC) arise in patients aged > or =70 years. The efficacy and safety of carboplatin-paclitaxel combination chemotherapy in elderly patients with advanced NSCLC were evaluated in a phase II trial.
Twenty-five patients aged > or =70 years (median, 76; range, 70-83) with chemotherapy-naive advanced NSCLC were enrolled between January 2001 and July 2003. Additional criteria included the presence of measurable lesions, an Eastern Cooperative Oncology Group performance status of 0 or 1, and adequate organ function. Patients received carboplatin at an area under the curve of 5 mg/ml/min and paclitaxel at 180 mg/m(2) on the first day of consecutive 3 week periods.
The patients included four with stage IIIB, 19 with stage IV and two with recurrent disease. The median number of treatment cycles was three (range, 1-4). One complete response and six partial responses, yielding an objective response rate of 28%, were obtained. The median survival time was 12.3 months and the 1-year survival rate was 52%. Hematological toxicities of grade 3 or 4 included leukopenia (40%), neutropenia (68%) and anemia (4%). Non-hematological toxicities of grade 3 included arthralgia-myalgia (16%) and neuropathy (12%). The objective response rate for patients aged > or =75 years (n = 15) was 26%, and no evidence of excessive toxicity in these patients was apparent compared with those aged <75 years.
The combination carboplatin-paclitaxel at these doses is a feasible treatment option with a favorable toxicity profile for fit elderly patients with advanced NSCLC.
超过30%的非小细胞肺癌(NSCLC)病例发生在年龄≥70岁的患者中。在一项II期试验中评估了卡铂-紫杉醇联合化疗在老年晚期NSCLC患者中的疗效和安全性。
2001年1月至2003年7月期间纳入了25例年龄≥70岁(中位年龄76岁;范围70 - 83岁)、未接受过化疗的晚期NSCLC患者。其他标准包括存在可测量病灶、东部肿瘤协作组(ECOG)体能状态为0或1以及器官功能良好。患者在连续3周周期的第一天接受曲线下面积为5mg/ml/min的卡铂和180mg/m²的紫杉醇治疗。
患者包括4例IIIB期、19例IV期和2例复发性疾病患者。中位治疗周期数为3个(范围1 - 4个)。获得1例完全缓解和6例部分缓解,客观缓解率为28%。中位生存时间为12.3个月,1年生存率为52%。3级或4级血液学毒性包括白细胞减少(40%)、中性粒细胞减少(68%)和贫血(4%)。3级非血液学毒性包括关节痛-肌痛(16%)和神经病变(12%)。年龄≥75岁(n = 15)患者的客观缓解率为26%,与年龄<75岁的患者相比,这些患者没有明显的过度毒性证据。
对于身体状况适合的老年晚期NSCLC患者,这些剂量的卡铂-紫杉醇联合治疗是一种可行的治疗选择,毒性特征良好。