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卡铂-紫杉醇联合化疗用于老年晚期非小细胞肺癌患者的II期研究

Phase II study of carboplatin-paclitaxel combination chemotherapy in elderly patients with advanced non-small cell lung cancer.

作者信息

Okamoto Isamu, Moriyama Eiji, Fujii Shinji, Kishi Hiroto, Nomura Masanobu, Goto Eisuke, Kiyofuji Chikage, Imamura Fumiya, Mori Takashi, Matsumoto Mitsuhiro

机构信息

Department of Respiratory Medicine, Kumamoto University, Kumamoto, Japan.

出版信息

Jpn J Clin Oncol. 2005 Apr;35(4):188-94. doi: 10.1093/jjco/hyi059.

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

The combination carboplatin-paclitaxel at these doses is a feasible treatment option with a favorable toxicity profile for fit elderly patients with advanced NSCLC.

摘要

背景

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。

方法

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。

结果

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。

结论

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。

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