Demirci Umut, Coskun Ugur, Karaca Halit, Dane Faysal, Ozdemir Nuriye Yildirim, Ulas Arife, Baykara Meltem, Benekli Mustafa, Ozkan Metin, Buyukberber Suleyman
Department of Medical Oncology, Dr. A.Y. Ankara Oncology Training and Research Hospital, Ankara, Turkey E-mail :
Asian Pac J Cancer Prev. 2014;15(4):1581-4. doi: 10.7314/apjcp.2014.15.4.1581.
The overall prognosis for cancers of unknown primary (CUP) is poor, median overall survival (OS) being 6-12 months. We evaluated our multicentric retrospective experience for CUP administered docetaxel and cisplatin combination therapy.
A total of 29 patients that were pathologically confirmed subtypes of CUP were included in the study. The combination of docetaxel (75 mg/m2, day 1) and cisplatin (75 mg/m2, day 1) was performed as a first line regimen every 21 days.
The median age was 51 (range: 27-68). Some 17 patients had multimetastatic disease on the inital diagnosis. Histopathological diagnoses were well-moderate differentiated adenocarcinoma (51.7%), undifferentiated carcinoma (27.6%), squamous cell cancer (13.8%), mucoepidermoid carcinoma (3.4%) and neuroendocrine differentiated carcinoma (3.4%). Median number of cycles was 3 (range: 1-6). Objective response rate was 37.9% and clinical benefit was 58.6%. Median progression free survival (PFS) and overall survival (OS) were 6 months (range: 4.3-7.7 months) and 16 months (range: 8.1-30.9 months), respectively. Fourteen patients (60.8%) were treated in a second line setting. There was no treatment related death. Most common toxicities were nausia-vomiting (44.6%) and fatigue (34.7%), serious cases (grade 3/4) suffering nausia-vomiting (10.3%), neutropenia (13.8%) and febrile neutropenia (n=1).
The combination of cisplatin and docetaxel is an effective regimen for selected patients with CUP.
原发灶不明癌（CUP）的总体预后较差，中位总生存期（OS）为6 - 12个月。我们评估了多中心回顾性研究中接受多西他赛和顺铂联合治疗的CUP患者的情况。
本研究纳入了29例经病理确诊的CUP亚型患者。多西他赛（75 mg/m²，第1天）和顺铂（75 mg/m²，第1天）联合用药，每21天作为一线治疗方案。
中位年龄为51岁（范围：27 - 68岁）。约17例患者初诊时已有多处转移。组织病理学诊断为中高分化腺癌（51.7%）、未分化癌（27.6%）、鳞状细胞癌（13.8%）、黏液表皮样癌（3.4%）和神经内分泌分化癌（3.4%）。中位周期数为3（范围：1 - 6）。客观缓解率为37.9%，临床获益率为58.6%。中位无进展生存期（PFS）和总生存期（OS）分别为6个月（范围：4.3 - 7.7个月）和16个月（范围：8.1 - 30.9个月）。14例患者（60.8%）接受了二线治疗。无治疗相关死亡。最常见的毒性反应是恶心呕吐（44.6%）和疲劳（34.7%），严重病例（3/4级）出现恶心呕吐（10.3%）、中性粒细胞减少（13.8%）和发热性中性粒细胞减少（n = 1）。
顺铂和多西他赛联合方案对部分CUP患者是有效的治疗方案。
