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口服长春瑞滨和顺铂联合诱导化疗后顺铂和多西他赛同步放化疗治疗局部晚期非小细胞肺癌患者:GFPC 05-03 研究。

Oral vinorelbine and cisplatin with concurrent radiotherapy after induction chemotherapy with cisplatin and docetaxel for patients with locally advanced non-small cell lung cancer: the GFPC 05-03 study.

机构信息

Institut de Cancérologie et Hématologie, Centre Hospitalier Universitaire Morvan, Brest, France.

出版信息

J Thorac Oncol. 2011 Feb;6(2):351-7. doi: 10.1097/JTO.0b013e318200f47e.

Abstract

INTRODUCTION

The aim of this multicenter phase II trial was to evaluate the combination of oral vinorelbine and cisplatin with radiotherapy (RT) after cisplatin-docetaxel induction chemotherapy (CT) in patients with locally advanced non-small cell lung cancer (NSCLC).

PATIENTS AND METHODS

Patients with previously untreated, inoperable, histologically or cytologically confirmed stage IIIA or IIIB NSCLC, with performance status ≤ 1 and weight loss ≤ 10% received two cycles of induction CT with cisplatin (75 mg/m) and docetaxel (75 mg/m) every 3 weeks. Patients with a tumor response or stabilization continued to receive cisplatin (80 mg/m) and oral vinorelbine (40 mg/m) on days 1 and 8 for two cycles, with concomitant thoracic RT (2 Gy/d, 5 d/wk, and total dose 66 Gy).

RESULTS

Fifty-six patients were enrolled. All patients (n = 38) who received CT-RT were assessable for the tumor response. There were no complete responses. In the intent-to-treat analysis, the response rates were 32.1% after induction CT and 41.1% after CT-RT. The median progression-free and overall survival times were 9.2 months (95% confidence interval: 7-14) and 20.8 months (95% confidence interval: 13.7-24.1), respectively. Adverse effects of RT-CT were grades 3 to 4 neutropenia (four patients) and grade 3 esophageal toxicity (one patient). No treatment-related deaths occurred.

CONCLUSION

The oral vinorelbine-cisplatin combination with concurrent RT is feasible and has a favorable risk-benefit ratio in stage IIIA/IIIB NSCLC.

摘要

简介

本多中心二期临床试验旨在评估在顺铂-多西他赛诱导化疗(CT)后,口服长春瑞滨和顺铂联合放疗(RT)在局部晚期非小细胞肺癌(NSCLC)患者中的疗效。

患者和方法

未经治疗、不可手术、组织学或细胞学证实的 IIIA 期或 IIIB 期 NSCLC、体力状态 ≤ 1 级和体重减轻 ≤ 10%的患者接受两个周期的顺铂(75mg/m)和多西他赛(75mg/m)诱导 CT,每 3 周一次。肿瘤有反应或稳定的患者继续接受两个周期的顺铂(80mg/m)和口服长春瑞滨(40mg/m),第 1 天和第 8 天给药,同时进行胸部 RT(2Gy/d,每周 5 天,总剂量 66Gy)。

结果

共纳入 56 例患者。所有接受 CT-RT 的患者(n=38)均可评估肿瘤反应。无完全缓解。意向治疗分析中,诱导 CT 后的反应率为 32.1%,CT-RT 后的反应率为 41.1%。中位无进展生存期和总生存期分别为 9.2 个月(95%置信区间:7-14)和 20.8 个月(95%置信区间:13.7-24.1)。RT-CT 的不良反应为 3-4 级中性粒细胞减少(4 例)和 3 级食管毒性(1 例)。无治疗相关死亡。

结论

口服长春瑞滨-顺铂联合同期 RT 治疗 IIIA/IIIB 期 NSCLC 是可行的,具有良好的风险效益比。

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