Saito Hiroshi, Kudoh Shinzoh, Nakagawa Kazuhiko, Negoro Shunichi, Matsui Kaoru, Semba Hiroshi, Takada Minoru
Department of Respiratory Medicine, Aichi Cancer Center Aichi Hospital, Okazaki, Japan.
Am J Clin Oncol. 2006 Oct;29(5):503-7. doi: 10.1097/01.coc.0000231432.22998.6a.
The combination of irinotecan and cisplatin given every 4 weeks is one of the standard treatments for advanced nonsmall-cell lung cancer (NSCLC) in Japan. The purpose of this study is to evaluate the efficacy, safety and dose-intensity as a measure of the feasibility of 3-week scheduling of irinotecan and cisplatin in patients with advanced NSCLC in phase II study.
Previously untreated patients with stage IIIB and IV NSCLC were treated intravenously with irinotecan (60 mg/m2) on days 1 and 8 and cisplatin (60 mg/m2) on day 1 of a 3-week cycle.
Of the 28 patients enrolled, 27 were evaluable for response and toxicity. The response rate was 30% (95% confidence interval, 14-50%). The median duration of response was 16 weeks (range, 10-26 weeks). The median survival time for all patients was 52 weeks and the 1-year and 2-year survival rates were 48% and 29%, respectively. The dose-intensity of irinotecan was 34 mg/m2/wk (range, 19-40). The major toxicities observed were neutropenia (grade 3, 30%; 4, 30%), leukopenia (grade 3, 30%), and diarrhea (grade 3, 22%). Other toxicities were generally mild.
Three-week scheduling of irinotecan and cisplatin is effective and feasible in advanced NSCLC.
在日本,每4周给予伊立替康和顺铂联合治疗是晚期非小细胞肺癌(NSCLC)的标准治疗方法之一。本研究的目的是在II期研究中评估伊立替康和顺铂3周给药方案在晚期NSCLC患者中的疗效、安全性及剂量强度,以此衡量该方案的可行性。
既往未接受过治疗的IIIB期和IV期NSCLC患者在3周周期的第1天和第8天静脉注射伊立替康(60mg/m²),并在第1天静脉注射顺铂(60mg/m²)。
入组的28例患者中,27例可评估疗效和毒性。缓解率为30%(95%置信区间,14 - 50%)。中位缓解持续时间为16周(范围,10 - 26周)。所有患者的中位生存时间为52周,1年和2年生存率分别为48%和29%。伊立替康的剂量强度为34mg/m²/周(范围,19 - 40)。观察到的主要毒性为中性粒细胞减少(3级,30%;4级,30%)、白细胞减少(3级,30%)和腹泻(3级,22%)。其他毒性一般较轻。
伊立替康和顺铂3周给药方案在晚期NSCLC中有效且可行。