Imai Hisao, Kaira Kyoichi, Mori Keita, Ono Akira, Akamatsu Hiroaki, Taira Tetsuhiko, Yoshino Reiko, Kenmotsu Hirotsugu, Saitoh Jun-Ichi, Harada Hideyuki, Naito Tateaki, Murakami Haruyasu, Tomizawa Yoshio, Matsuura Masana, Saito Ryusei, Nakajima Takashi, Yamada Masanobu, Takahashi Toshiaki
Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi, Suntou-gun Shizuoka, 411-8777 Japan ; Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511 Japan.
Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi, Suntou-gun Shizuoka, 411-8777 Japan ; Department of Oncology Clinical Development, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511 Japan.
Springerplus. 2015 Mar 31;4:152. doi: 10.1186/s40064-015-0929-3. eCollection 2015.
Platinum-based chemoradiotherapy (CRT) is a standard front-line treatment for locally advanced non-small cell lung cancer (NSCLC). However, no clinical trials have compared the efficacy and toxicity of platinum combination and docetaxel as subsequent re-challenge chemotherapies after cancer recurrence following CRT. This study aimed to evaluate the efficacy and toxicity of platinum combination chemotherapy versus docetaxel monotherapy in NSCLC patients previously treated with platinum-based CRT. From September 2002 to December 2009, at three participating institutions, 24 patients with locally advanced NSCLC, who had previously received platinum-based CRT, were treated with platinum combination re-challenge therapy, whereas 61 received docetaxel monotherapy. We reviewed their medical charts to evaluate patient characteristics and data regarding treatment response, survival, and toxicity. The response rates were 16.7% and 6.6% in the platinum combination chemotherapy and docetaxel monotherapy groups, respectively (p = 0.09), whereas disease control rates were 58.3% and 57.4%, respectively (p = 0.82). Progression-free survival was similar between the two groups (median, 4.2 vs. 2.3 months; hazard ratio [HR] = 0.81; 95% confidence interval [CI] = 0.51-1.29; p = 0.38), as was overall survival (median, 16.5 vs. 13.0 months; HR = 0.82; 95% CI = 0.47-1.41; p = 0.47). The incidence and severity of toxicity was also similar between the two groups. Hematological toxicity, particularly leukopenia and neutropenia, was more frequent in the docetaxel group. Our results indicated that platinum combination re-challenge was equivalent to docetaxel for relapsed patients previously treated with platinum-based CRT.
铂类同步放化疗（CRT）是局部晚期非小细胞肺癌（NSCLC）的标准一线治疗方法。然而，尚无临床试验比较铂类联合与多西他赛作为CRT后癌症复发的后续再挑战化疗的疗效和毒性。本研究旨在评估铂类联合化疗与多西他赛单药治疗在先前接受铂类CRT治疗的NSCLC患者中的疗效和毒性。2002年9月至2009年12月，在三个参与机构中，24例先前接受铂类CRT治疗的局部晚期NSCLC患者接受了铂类联合再挑战治疗，而61例接受了多西他赛单药治疗。我们查阅了他们的病历，以评估患者特征以及有关治疗反应、生存和毒性的数据。铂类联合化疗组和多西他赛单药治疗组的缓解率分别为16.7%和6.6%（p = 0.09），而疾病控制率分别为58.3%和57.4%（p = 0.82）。两组的无进展生存期相似（中位数，4.2个月对2.3个月；风险比[HR]=0.81；95%置信区间[CI]=0.51 - 1.29；p = 0.38），总生存期也相似（中位数，16.5个月对13.0个月；HR = 0.82；95%CI = 0.47 - 1.41；p = 0.47）。两组的毒性发生率和严重程度也相似。血液学毒性，尤其是白细胞减少和中性粒细胞减少，在多西他赛组中更常见。我们的结果表明，对于先前接受铂类CRT治疗的复发患者，铂类联合再挑战与多西他赛等效。
