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辅助卡铂和多西他赛在可切除局部晚期非小细胞肺癌患者中的可行性。

The feasibility of adjuvant carboplatin and docetaxel in patients with curatively resected locally advanced non-small cell lung cancer.

机构信息

Cancer Center of Sun Yat-sen University, Guangzhou, PR China.

出版信息

Lung Cancer. 2010 Jun;68(3):403-8. doi: 10.1016/j.lungcan.2009.10.002. Epub 2009 Nov 12.

Abstract

BACKGROUND

Adjuvant cisplatin-based chemotherapy benefits selected patients with stages II and III non-small cell lung cancer (NSCLC). However, carboplatin being tolerated better than cisplatin, carboplatin-based adjuvant therapy may have better chemotherapy compliance. This study aimed to investigate the feasibility and toxicity of adjuvant carboplatin and docetaxel in patients with completely resected locally advanced NSCLC.

METHODS

Eighty patients with completely resected locally advanced NSCLC were enrolled in this trial. Adjuvant chemotherapy was initiated between 1 and 4 weeks after surgery, and consisted of four cycles of carboplatin (AUC=5), and docetaxel (Taxotere, 75mg/m(2)) every 3 weeks, after which patients received prophylactic G-CSF supportive therapy.

RESULTS

Patient demographics were: Median age 55 years (range 34-73): gender ratio was 56.3% male/43.7% female: 72.5% of the patients were at stage IIIA and 27.5% were at stage IIIB. The two most common histologies were adenocarcinoma (62.5%) and squamous cell carcinoma (17.5%). Sixty-six patients (82.5%) received four cycles of therapy over a 12-week period. Fourteen patients (17.5%) did not complete therapy due to: patient refusal (n=12), severe adverse events (n=1) and bone metastases during chemotherapy (n=1). No treatment related deaths were observed and the primary adverse events were hematologic toxicity, alopecia, fatigue and gastointestinal reaction (nausea, vomiting and diarrhea).

CONCLUSION

Combination therapy with carboplatin and docetaxel with the use of G-CSF supportive therapy has an acceptable toxicity profile such that the majority of patients completed four cycles of therapy in 12 weeks.

摘要

背景

含顺铂的辅助化疗使部分 II 期和 III 期非小细胞肺癌(NSCLC)患者获益。然而,由于卡铂的耐受性优于顺铂,卡铂为基础的辅助治疗可能具有更好的化疗顺应性。本研究旨在探讨完全切除的局部晚期 NSCLC 患者接受卡铂和多西紫杉醇辅助治疗的可行性和毒性。

方法

本试验纳入 80 例完全切除的局部晚期 NSCLC 患者。辅助化疗于术后 1-4 周开始,共 4 个周期,每 3 周用卡铂(AUC=5)和多西紫杉醇(Taxotere,75mg/m2),之后患者接受预防性 G-CSF 支持治疗。

结果

患者的人口统计学特征为:中位年龄 55 岁(范围 34-73 岁);性别比为 56.3%男性/43.7%女性;72.5%的患者处于 IIIA 期,27.5%的患者处于 IIIB 期。最常见的两种组织学类型为腺癌(62.5%)和鳞状细胞癌(17.5%)。66 例患者(82.5%)在 12 周内接受了 4 个周期的治疗。由于患者拒绝(n=12)、严重不良事件(n=1)和化疗期间发生骨转移(n=1),14 例患者(17.5%)未完成治疗。未观察到与治疗相关的死亡,主要的不良事件为血液学毒性、脱发、乏力和胃肠道反应(恶心、呕吐和腹泻)。

结论

卡铂和多西紫杉醇联合 G-CSF 支持治疗的联合治疗具有可接受的毒性谱,大多数患者在 12 周内完成了 4 个周期的治疗。

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