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多西他赛与卡铂用于老年晚期非小细胞肺癌患者的II期研究。

Phase II study of docetaxel and carboplatin in elderly patients with advanced non-small cell lung cancer.

作者信息

Yoshimura Naruo, Kudoh Shinzoh, Kimura Tatsuo, Mitsuoka Shigeki, Kyoh Shigenori, Tochino Yoshihiro, Asai Kazuhisa, Kodama Toyoki, Ichimaru Yukikazu, Yana Takashi, Hirata Kazuto

机构信息

Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan.

出版信息

J Thorac Oncol. 2009 Mar;4(3):371-5. doi: 10.1097/JTO.0b013e31819846e4.

Abstract

BACKGROUND

Mainly single-agent chemotherapy has been considered as standard treatment for elderly patients with non-small cell lung cancer (NSCLC). Docetaxel monotherapy is regarded as a standard treatment for elderly patients with advanced NSCLC, and recent subset analyses have suggested that platinum-based chemotherapy can be safely used in the elderly. This phase II study was conducted to evaluate the efficacy and safety of docetaxel and carboplatin in elderly patients with advanced NSCLC.

METHODS

Patients enrolled in this study had stage IIIB or IV NSCLC with measurable disease, no prior chemotherapy, Eastern Cooperative Oncology Group performance status of 0-2, and were 70 years or older. Treatment consisted of docetaxel at a dose of 60 mg/m(2) and carboplatin at area under the curve of 5 mg/ml/min on day 1 every 3 weeks.

RESULTS

From October 2003 to April 2006, 30 patients were enrolled. One complete response and 13 partial responses were observed, for an overall response rate of 46.7% (95% confidence interval: 28.8-64.6%). Median progression-free survival and overall survival periods were 4.4 months and 9.9 months, respectively. One-year survival rate was 43.3%. Major grade 3 and 4 hematological toxicities included neutropenia (86.7%), leucopenia (80.0%) and febrile neutropenia (16.7%). Major grade 3 nonhematological toxicities were anorexia (30.0%) and diarrhea (13.3%). There were no grade 4 nonhematological toxicities or treatment-related deaths.

CONCLUSIONS

Docetaxel combined with carboplatin was an active treatment with manageable toxicity for the treatment of elderly patients with chemotherapy-naive NSCLC.

摘要

背景

单药化疗一直被视为老年非小细胞肺癌(NSCLC)患者的标准治疗方法。多西他赛单药治疗被认为是老年晚期NSCLC患者的标准治疗方法,最近的亚组分析表明铂类化疗可安全用于老年人。本II期研究旨在评估多西他赛和卡铂治疗老年晚期NSCLC患者的疗效和安全性。

方法

本研究纳入的患者为IIIB期或IV期NSCLC,具有可测量病灶,未接受过化疗,东部肿瘤协作组体能状态为0 - 2,年龄在70岁及以上。治疗方案为每3周的第1天给予多西他赛剂量为60 mg/m²,卡铂曲线下面积为5 mg/ml/min。

结果

2003年10月至2006年4月,共纳入30例患者。观察到1例完全缓解和13例部分缓解,总缓解率为46.7%(95%置信区间:28.8 - 64.6%)。中位无进展生存期和总生存期分别为4.4个月和9.9个月。1年生存率为43.3%。主要的3级和4级血液学毒性包括中性粒细胞减少(86.7%)、白细胞减少(80.0%)和发热性中性粒细胞减少(16.7%)。主要的3级非血液学毒性为厌食(30.0%)和腹泻(13.3%)。无4级非血液学毒性或治疗相关死亡。

结论

多西他赛联合卡铂是一种对未接受过化疗的老年NSCLC患者有效的治疗方法,且毒性可控。

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