Miyazaki Akihiro, Kobayashi Junichi, Yamamoto Takashi, Kido Yukie, Takemura Kanako, Abe Masato, Tomihara Kei, Dehari Hironari, Nakamori Kenji, Nagai Itaru, Hiratsuka Hiroyoshi
Department of Oral Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo 060-8543, Japan.
Oral Oncol. 2008 May;44(5):471-6. doi: 10.1016/j.oraloncology.2007.06.005. Epub 2007 Sep 7.
The purpose of this clinical trial was to assess the toxicity and efficacy of docetaxel plus nedaplatin induction chemotherapy in patients with locally advanced oral squamous cell carcinoma (OSCC). Twenty-one patients were enrolled in this phase I/II clinical study. The toxicities, response rates, and the maximum tolerated dose of nedaplatin that could be safely given preoperatively were assessed. Patients received escalating doses of nedaplatin (60, 70, 80, 90 mg/m2) combined with a fixed dose of docetaxel (60 mg/m2) on day one. Dose-limiting toxicity (DLT), grade 4 leukopenia lasting for two days or more, was seen in one patient at dose level 3; no other DLT was observed at any dose level. The overall response rate was 66.7%. The response rate was 100% at nedaplatin dose level 4, while that at dose level 1 was low (33.3%). Given these results, the recommended dose of nedaplatin in this regimen combined with fixed dose docetaxel (60 mg/m2) was determined to be 90 mg/m2. Docetaxel 60 mg/m2 plus nedaplatin 90 mg/m2 induction chemotherapy can be recommended for patients with locally advanced oral squamous cell carcinoma. Based on these results, an early phase II clinical study using this dose level was conducted; docetaxel plus nedaplatin induction chemotherapy appears to be a useful regimen for the treatment of OSCC. A late phase II clinical study is warranted.
本临床试验的目的是评估多西他赛联合奈达铂诱导化疗对局部晚期口腔鳞状细胞癌(OSCC)患者的毒性和疗效。21例患者参加了这项I/II期临床研究。评估了毒性、缓解率以及术前可安全给予的奈达铂的最大耐受剂量。患者在第1天接受递增剂量的奈达铂(60、70、80、90mg/m²)联合固定剂量的多西他赛(60mg/m²)。在剂量水平3时,1例患者出现剂量限制性毒性(DLT),即4级白细胞减少持续两天或更长时间;在任何剂量水平均未观察到其他DLT。总体缓解率为66.7%。奈达铂剂量水平4时的缓解率为100%,而剂量水平1时较低(33.3%)。鉴于这些结果,确定在该方案联合固定剂量多西他赛(60mg/m²)中奈达铂的推荐剂量为90mg/m²。对于局部晚期口腔鳞状细胞癌患者,可推荐多西他赛60mg/m²加奈达铂90mg/m²诱导化疗。基于这些结果,进行了使用该剂量水平的早期II期临床研究;多西他赛联合奈达铂诱导化疗似乎是治疗OSCC的有效方案。有必要开展晚期II期临床研究。