Department of Internal Medicine, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University, Gangdong gu, Seoul, South Korea.
Cancer Chemother Pharmacol. 2010 Oct;66(5):889-97. doi: 10.1007/s00280-009-1235-y. Epub 2010 Jan 21.
Docetaxel and cisplatin combination chemotherapy is established first-line chemotherapy for advanced non-small cell lung cancer (NSCLC). We evaluated a weekly schedule of docetaxel and cisplatin for efficacy and tolerability in patients with chemotherapy-naive NSCLC.
Patients enrolled in this study had stage IIIB or IV NSCLC with measurable disease, no prior chemotherapy, and Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-2. Treatment consisted of docetaxel 40 mg/m(2) and cisplatin 35 mg/m(2) given on D1 and D8 every 3 weeks. Patients were evaluated for response after every 2 cycles of treatment.
Thirty six patients were enrolled, and 35 underwent treatment. Of these, 29 were males and 7 females, median age was 61 years (range, 38-68). About 31 patients had ECOG PS 0-1 and 4 patients had ECOG PS 2. Fifty seven percentage (20/35) of patients had adenocarcinoma and 74.3% (26/35) had stage IV disease. A total of 153 cycles of chemotherapy were administered. Of the 35 patients treated, 17 (48.6%) achieved partial response, 11 (31.4%) showed stable disease, and 6 (17.1%) had progressive disease. Median duration of response was 5.3 months (95% CI: 4.2-6.2 months), and median time to disease progression was 4.6 months (95% CI: 2.9-6.3 months). Estimated overall survival at 1 year was 65.7%. The major hematologic toxicity was myelosuppression. Grade 3 or 4 anemia occurred in 6 cycles, and grade 3 or 4 neutropenia was observed in four cycles. Major non-hematologic toxicities were grade 3 nausea in three patients and grade 3 fatigue in two patients. Three patients developed pneumonia and one patient had infectious colitis. There were no treatment-related deaths in this study.
Weekly schedule of docetaxel and cisplatin as first-line treatment for NSCLC had good efficacy and manageable toxicity.
多西他赛和顺铂联合化疗是晚期非小细胞肺癌(NSCLC)的标准一线化疗方案。我们评估了每周一次多西他赛和顺铂方案治疗初治 NSCLC 患者的疗效和耐受性。
该研究纳入的患者为 IIIB 或 IV 期可测量疾病的 NSCLC 患者,无既往化疗史,且东部肿瘤协作组(ECOG)体能状态(PS)为 0-2 分。治疗方案为多西他赛 40mg/m²和顺铂 35mg/m²,于第 1 天和第 8 天给药,每 3 周 1 次。每 2 个周期治疗后对患者进行疗效评价。
共纳入 36 例患者,其中 35 例患者接受了治疗。29 例为男性,7 例为女性,中位年龄为 61 岁(范围,38-68 岁)。31 例患者的 ECOG PS 为 0-1 分,4 例患者的 ECOG PS 为 2 分。57%(20/35)的患者为腺癌,74.3%(26/35)的患者为 IV 期疾病。共给予 153 个周期的化疗。35 例患者中,17 例(48.6%)获得部分缓解,11 例(31.4%)病情稳定,6 例(17.1%)疾病进展。中位缓解持续时间为 5.3 个月(95%CI:4.2-6.2 个月),中位疾病进展时间为 4.6 个月(95%CI:2.9-6.3 个月)。1 年总生存率估计为 65.7%。主要血液学毒性为骨髓抑制。6 个周期发生 3 或 4 级贫血,4 个周期发生 3 或 4 级中性粒细胞减少。主要非血液学毒性为 3 级恶心 3 例,3 级乏力 2 例。3 例患者发生肺炎,1 例患者发生感染性结肠炎。本研究无治疗相关死亡。
每周一次多西他赛和顺铂作为 NSCLC 的一线治疗方案具有较好的疗效和可管理的毒性。