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氨柔比星单药治疗既往接受过治疗的老年肺癌患者。

Amrubicin monotherapy for elderly patients with previously treated lung cancer.

作者信息

Nakao Makoto, Oguri Tetsuya, Suzuki Takeshi, Kunii Eiji, Tomita Yuki, Iwashima Yasuhito, Miyazaki Mikinori, Maeno Ken, Sato Shigeki, Ueda Ryuzo

机构信息

Department of Medical Oncology and Immunology, Nagoya City University School of Medical Sciences, Nagoya, Japan.

出版信息

Intern Med. 2010;49(17):1857-62. doi: 10.2169/internalmedicine.49.3606. Epub 2010 Sep 1.

Abstract

OBJECTIVE

The novel anthracycline agent amrubicin, has been approved in Japan to treat small and non-small cell lung cancers (SCLC and NSCLC). The present study evaluates the toxicity and effect of amrubicin especially in elderly patients with previously treated lung cancer.

PATIENTS AND METHODS

This retrospective study analyzed data from 51 patients (<70 years of age, n=29; > oor =70 years of age, n=22) with lung cancer (NSCLC, n=21; SCLC, n=30) who were treated with amrubicin at our hospital, between July 2003 and October 2009. All patients had recurrent or refractory lung cancer after one or more chemotherapy regimens. We compared the outcomes of patients younger and older than 70 years of age. Amrubicin (30-40 mg/m(2)/day) was infused depending on patient performance status and laboratory data over a period of 5 minutes on days 1-3, with courses repeated at intervals of at least 3 weeks. The dose was modified according to myelosuppression.

RESULTS

The mean number of treatment cycles, mean dose and mean interval of amrubicin administration did not significantly differ between patients aged <70 and > or =70 years. The rate of hematological toxicities (> or = Grade 3) also did not significantly differ between the two age groups (leukopenia, 48.3% and 59.1% for age <70 and > or =70 years, p=0.573; neutropenia, 65.5% vs. 77.3%, p=0.536; anemia, 20.7% vs. 22.7%, p=1.000; thrombocytopenia, 13.8% vs. 31.8%, p=0.173). The incidence of grade 2-4 non-hematological toxicities also did not significantly differ between the groups. The response rate of SCLC and disease control rate of NSCLC were similar in the younger and older groups.

CONCLUSION

Amrubicin monotherapy might be equally tolerated by elderly and younger patients. Further studies are needed to investigate the benefit of amrubicin monotherapy among elderly patients with previously treated lung cancer.

摘要

目的

新型蒽环类药物氨柔比星已在日本获批用于治疗小细胞肺癌和非小细胞肺癌(SCLC和NSCLC)。本研究评估氨柔比星的毒性和疗效,尤其是在既往接受过治疗的老年肺癌患者中的情况。

患者与方法

本回顾性研究分析了2003年7月至2009年10月期间在我院接受氨柔比星治疗的51例肺癌患者的数据(年龄<70岁,n = 29;年龄≥70岁,n = 22),其中非小细胞肺癌(NSCLC)21例,小细胞肺癌(SCLC)30例。所有患者在接受一种或多种化疗方案后出现复发或难治性肺癌。我们比较了年龄小于70岁和大于或等于70岁患者的治疗结果。根据患者的体能状态和实验室数据,在第1 - 3天的5分钟内静脉输注氨柔比星(30 - 40mg/m²/天),疗程至少间隔3周重复进行。剂量根据骨髓抑制情况进行调整。

结果

年龄<70岁和≥70岁的患者在氨柔比星治疗周期数、平均剂量和平均给药间隔方面无显著差异。两个年龄组的血液学毒性(≥3级)发生率也无显著差异(白细胞减少症,年龄<70岁组为48.3%,年龄≥70岁组为59.1%,p = 0.573;中性粒细胞减少症,分别为65.5%和77.3%,p = 0.536;贫血,分别为20.7%和22.7%,p = 1.000;血小板减少症,分别为13.8%和31.8%,p = 0.173)。2 - 4级非血液学毒性的发生率在两组间也无显著差异。年轻组和老年组中SCLC的缓解率和NSCLC的疾病控制率相似。

结论

老年和年轻患者对氨柔比星单药治疗的耐受性可能相同。需要进一步研究以探讨氨柔比星单药治疗在既往接受过治疗的老年肺癌患者中的获益情况。

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