Department of Respiratory Medicine, Juntendo University, School of Medicine, Bunkyou-ku, Tokyo, Japan.
Anticancer Res. 2010 Oct;30(10):4357-61.
Since advanced non-small cell lung cancer (NSCLC) patients with the interstitial lung disease (ILD) have been excluded from clinical trials, it is uncertain whether chemotherapy really provides a benefit to these patients.
Fifteen advanced NSCLC patients with ILD that was detected on the chest X-rays were enrolled in this study. Carboplatin plus paclitaxel was administered by two methods (method A or method B). Method A: Carboplatin (AUC 6, day 1) and paclitaxel (70 mg/m(2), days 1, 8, 15) were administered every four weeks. Method B: Carboplatin (AUC 2, day 1, 8, 15) and paclitaxel (60 mg/m(2), days 1, 8, 15) were administered every four weeks.
The response rate and the disease control rate were 33% and 53%. The median progression-free survival and the median overall survival time were 2.5 months and 7.0 months, respectively. The hematological toxicities were tolerable, but a grade 3 or higher pneumonitis was observed in 4 patients (27%).
Carboplatin plus weekly paclitaxel must be administered carefully to advanced NSCLC patients with ILD that is detected on chest X-rays after a sufficient evaluation of the risks and the benefits.
由于有间质性肺病（ILD）的晚期非小细胞肺癌（NSCLC）患者已被排除在临床试验之外，因此尚不确定化疗是否确实对这些患者有益。
本研究共纳入了 15 名胸部 X 射线检查发现有ILD 的晚期 NSCLC 患者。采用两种方法（方法 A 或方法 B）给予卡铂加紫杉醇治疗。方法 A：卡铂（AUC 6，第 1 天）和紫杉醇（70mg/m²，第 1、8、15 天）每四周给药一次。方法 B：卡铂（AUC 2，第 1、8、15 天）和紫杉醇（60mg/m²，第 1、8、15 天）每四周给药一次。
缓解率和疾病控制率分别为 33%和 53%。中位无进展生存期和中位总生存期分别为 2.5 个月和 7.0 个月。血液学毒性可耐受，但 4 名患者（27%）出现了 3 级或更高级别的肺炎。
在充分评估风险和获益后，对于胸部 X 射线检查发现有ILD 的晚期 NSCLC 患者，必须谨慎给予卡铂加每周紫杉醇治疗。
