National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
Br J Cancer. 2013 Aug 6;109(3):545-51. doi: 10.1038/bjc.2013.378. Epub 2013 Jul 18.
We conducted a multicentre feasibility study for single agent long-term S-1 chemotherapy following docetaxel plus cisplatin in patients with curatively resected stage II-IIIA non-small cell lung cancer.
Patients received three cycles of docetaxel (60 mg m(-2)) plus cisplatin (80 mg m(-2)) and then received S-1 (40 mg m(-2) twice daily) for 14 consecutive days with a 1-week rest for >6 months (maximum, 1 year). The primary end point was feasibility, which was defined as the proportion of patients who completed eight or more cycles of S-1 chemotherapy. If the lower 95% confidence interval (CI) of this proportion was 50% or more, then the treatment was considered as feasible. The sample size was set at 125 patients.
One hundred and thirty-one patients were enrolled, of whom 129 patients were eligible and assessable. In all, 109 patients (84.5%) completed 3 cycles of docetaxel plus cisplatin and 66 patients (51.2%, 95% CI: 42.5-59.8) completed 8 or more cycles of S-1 treatment. Grade 3/4 toxicities during the S-1 chemotherapy included anaemia (7.3%), neutropaenia (3.7%), and anorexia (3.7%).
The toxicity level was acceptable, although the results did not meet our criterion for feasibility. Modification of the treatment schedule for S-1 chemotherapy might improve the treatment compliance.
我们进行了一项多中心可行性研究,即在接受多西他赛加顺铂治疗后,对可切除的 II 期-IIIA 期非小细胞肺癌患者进行单药长期 S-1 化疗。
患者接受三个周期的多西他赛(60mg/m²)加顺铂(80mg/m²)治疗,然后接受 S-1(40mg/m²,每日两次)治疗 14 天,休息 1 周>6 个月(最长 1 年)。主要终点是可行性,定义为完成 8 个或更多周期 S-1 化疗的患者比例。如果该比例的下 95%置信区间(CI)为 50%或更高,则认为该治疗可行。样本量设定为 125 例患者。
共纳入 131 例患者,其中 129 例患者符合入组条件并可评估。共有 109 例患者(84.5%)完成了 3 个周期的多西他赛加顺铂治疗,66 例患者(51.2%,95%CI:42.5-59.8)完成了 8 个或更多周期的 S-1 治疗。S-1 化疗期间出现 3/4 级毒性包括贫血(7.3%)、中性粒细胞减少(3.7%)和厌食(3.7%)。
毒性水平可接受,尽管结果未达到我们的可行性标准。S-1 化疗方案的修改可能会提高治疗依从性。