Department of Thoracic Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei, Taiwan, ROC.
Chemotherapy. 2011;57(2):147-55. doi: 10.1159/000321037. Epub 2011 Mar 31.
Docetaxel and pemetrexed have been validated as therapeutics for previously treated advanced non-small-cell lung cancer (NSCLC), but tolerability is a concern for standard treatment with docetaxel administered once every 3 weeks (tri-weekly 75-mg/m(2) schedule). We conducted this retrospective study to compare the efficacy and toxicity of weekly low-dose docetaxel versus tri-weekly pemetrexed for previously treated advanced NSCLC.
Consecutive patients who received low-dose single docetaxel (30 mg/m(2) on days 1 and 8 every 3 weeks) or pemetrexed (500 mg/m(2) every 3 weeks) at a single university-affiliated hospital following failure of previous treatment were retrospectively reviewed. Their outcomes and toxicity profiles were determined.
179 patients were included between 2005 and 2008 (docetaxel, n = 79; pemetrexed, n = 100). Both groups had similar hematologic (16.5 vs. 15.0%; p = 0.84) and non-hematologic (20.3 vs. 24%; p = 0.55) toxicities. After controlling for confounding factors, docetaxel remained superior to pemetrexed for progression-free survival (median 4.0 vs. 2.4 months; hazard ratio 0.64; 95% CI 0.47-0.87; p = 0.005) and overall survival (median 15.0 vs.8.5 months; hazard ratio 0.54; 95% CI 0.38-0.77; p <0.001).
Although this study showed that weekly low doses of docetaxel were as tolerable as pemetrexed for previously treated advanced NSCLC, a prospective design is needed to confirm this finding.
多西他赛和培美曲塞已被验证可用于治疗先前治疗的晚期非小细胞肺癌（NSCLC），但标准治疗中每 3 周给予多西他赛（75mg/m²，三周方案）的耐受性令人担忧。我们进行了这项回顾性研究，以比较每周低剂量多西他赛与三周培美曲塞治疗先前治疗的晚期 NSCLC 的疗效和毒性。
连续的患者在之前的治疗失败后在一家大学附属医院接受低剂量单药多西他赛（30mg/m²，每 3 周第 1 天和第 8 天）或培美曲塞（500mg/m²，每 3 周）治疗。回顾性分析他们的结局和毒性谱。
2005 年至 2008 年间共纳入 179 例患者（多西他赛组，n=79；培美曲塞组，n=100）。两组的血液学毒性（16.5% vs. 15.0%；p=0.84）和非血液学毒性（20.3% vs. 24%；p=0.55）相似。在控制混杂因素后，多西他赛在无进展生存期（中位数 4.0 个月 vs. 2.4 个月；风险比 0.64；95%CI 0.47-0.87；p=0.005）和总生存期（中位数 15.0 个月 vs. 8.5 个月；风险比 0.54；95%CI 0.38-0.77；p<0.001）方面仍优于培美曲塞。
尽管这项研究表明，先前治疗的晚期 NSCLC 患者每周接受低剂量多西他赛与培美曲塞一样耐受，但仍需要前瞻性设计来证实这一发现。
