Gore M E, Calvert A H, Smith L E
Lung Unit, Royal Marsden Hospital, Sutton, Surrey, U.K.
Eur J Cancer Clin Oncol. 1987 Sep;23(9):1391-7. doi: 10.1016/0277-5379(87)90125-8.
Sixteen patients with lung cancer or mesothelioma have been treated with escalating doses of carboplatin. Five patients (10 courses) were given 800 mg/m2, four patients (five courses) 1200 mg/m2 and seven patients (eight courses) 1600 mg/m2. Myelosuppression was the major toxicity encountered. The median duration of grade 4 neutropenia ranged from 1 day (800 mg/m2) to 11 days (1600 mg/m2) and the median duration of grade 4 thrombocytopenia ranged from 1 day (800 mg/m2) to 7 days (1600 mg/m2). The median fall in haemoglobin (Hb) ranged from 2.2 g/l (800 mg/m2) to 3.6 g/l (1600 mg/m2). Nephrotoxicity was encountered at all dosages and was in part, though not entirely, dose related. 2/9 patients receiving 800 mg/m2 and 4/6 of the patients receiving 1600 mg/m2 had a fall in glomerular filtration rate (GFR) greater than 25% but less than 50%. 800 mg/m2 of carboplatin was well tolerated, the performance status in 9/10 (90%) courses being 0-1 (ECOG scale). At 1600 mg/m2 in 6/8 (75%) courses the performance status was 2-4. There was one treatment-related death from neutropenia at this dose level. The severity of nausea and vomiting was not dose related but other toxicities including diarrhoea, alopecia, mild neuropathy and ototoxicity and possible CNS toxicity occurred at doses of 1200 mg/m2 and over. 5/7 patients with small cell lung cancer achieved a complete or partial response to treatment.
16例肺癌或间皮瘤患者接受了递增剂量的卡铂治疗。5例患者（10个疗程）给予800mg/m²，4例患者（5个疗程）给予1200mg/m²，7例患者（8个疗程）给予1600mg/m²。骨髓抑制是主要的毒性反应。4级中性粒细胞减少的中位持续时间从1天（800mg/m²）到11天（1600mg/m²），4级血小板减少的中位持续时间从1天（800mg/m²）到7天（1600mg/m²）。血红蛋白（Hb）的中位下降幅度从2.2g/l（800mg/m²）到3.6g/l（1600mg/m²）。所有剂量均出现肾毒性，且部分（尽管不是全部）与剂量相关。接受800mg/m²的2/9患者和接受1600mg/m²的4/6患者肾小球滤过率（GFR）下降超过25%但小于50%。800mg/m²的卡铂耐受性良好，9/10（90%）疗程的体能状态为0-1（东部肿瘤协作组[ECOG]量表）。在1600mg/m²时，6/8（75%）疗程的体能状态为2-4。在此剂量水平有1例因中性粒细胞减少导致的治疗相关死亡。恶心和呕吐的严重程度与剂量无关，但在1200mg/m²及以上剂量时出现了包括腹泻、脱发、轻度神经病变、耳毒性以及可能的中枢神经系统毒性等其他毒性反应。5/7例小细胞肺癌患者对治疗有完全或部分反应。
