Ohguri Takayuki, Imada Hajime, Narisada Hiroyuki, Yahara Katsuya, Morioka Tomoaki, Nakano Keita, Miyaguni Yasuhiro, Korogi Yukunori
Department of Radiology, University of Occupational and Environmental Health, Kitakyushu, Japan.
Int J Hyperthermia. 2009 Mar;25(2):160-7. doi: 10.1080/02656730802610357.
The purpose of this retrospective case series was to evaluate the toxicity and efficacy of systemic chemotherapy using paclitaxel and carboplatin plus regional hyperthermia (HT) and hyperbaric oxygen treatment (HBO) for non-small-cell lung cancer (NSCLC).
Twenty-two patients with NSCLC with multiple pulmonary metastases intravenously received paclitaxel (50 mg/m(2)), carboplatin (area under the curve of 1.0-1.5) and 10% glucose weekly for 3 out of 4 weeks. Hyperthermia (HT) of the whole thoracic region was also administered weekly during intravenous infusion of carboplatin in all patients. In addition, 16 (72%) of 22 patients received hyperbaric oxygen (HBO) treatment immediately after weekly chemotherapy. A total of 107 cycles were performed in 16 patients with HBO, and 27 cycles in 6 patients without HBO. The toxicity and efficacy of these patients were retrospectively analyzed.
Both the hematologic and non-hematologic toxicities were mild and leucopenia/neutropenia of > or = grade 3 was seen in one patient, while pneumonitis of > or = grade 3 occurred in one patient. Fourteen (64%) of 22 patients had an objective response. The median time to progression of disease in all patients was 8 months and in 16 patients with HBO was 9 months. Four (44%) of 9 patients with prior chemotherapy including paclitaxel and carboplatin obtained objective responses.
The novel combined therapy of paclitaxel and carboplatin with HT and HBO may therefore be a feasible and promising modality for treating NSCLC with multiple pulmonary metastases, and the results justify further evaluation to clarify the benefits of this treatment regimen.
本回顾性病例系列研究旨在评估紫杉醇、卡铂联合区域热疗（HT）和高压氧治疗（HBO）对非小细胞肺癌（NSCLC）进行全身化疗的毒性和疗效。
22例伴有多发肺转移的NSCLC患者静脉注射紫杉醇（50mg/m²）、卡铂（曲线下面积为1.0 - 1.5）和10%葡萄糖，每4周中的3周每周给药一次。所有患者在静脉输注卡铂期间，每周也进行全胸热疗（HT）。此外，22例患者中有16例（72%）在每周化疗后立即接受高压氧（HBO）治疗。16例接受HBO治疗的患者共进行了107个周期，6例未接受HBO治疗的患者进行了27个周期。对这些患者的毒性和疗效进行回顾性分析。
血液学和非血液学毒性均较轻，1例患者出现≥3级白细胞减少/中性粒细胞减少，1例患者出现≥3级肺炎。22例患者中有14例（64%）出现客观缓解。所有患者疾病进展的中位时间为8个月，16例接受HBO治疗的患者为9个月。9例既往接受过包括紫杉醇和卡铂化疗的患者中有4例（44%）获得客观缓解。
因此，紫杉醇和卡铂联合HT和HBO的新型联合疗法可能是治疗伴有多发肺转移的NSCLC的一种可行且有前景的治疗方式，这些结果证明有必要进一步评估以明确该治疗方案的益处。
