Bentzen Jens K D, Kristensen Claus Andrup, Overgaard Marie, Rytter Carsten, Jensen Kenneth, Hansen Hanne Sand
Department of Oncology, Herlev Hospital, Herlev, Denmark.
Department of Oncology, The Finsen Centre, Rigshospitalet, Copenhagen, Denmark.
Front Oncol. 2018 Jun 29;8:243. doi: 10.3389/fonc.2018.00243. eCollection 2018.
This study presents the results of an extended phase II study originally published in 2007, regarding the antitumor activity and toxicity of a non-platinum containing regimen with paclitaxel and capecitabine for the treatment of recurrent or disseminated squamous cell carcinoma of the head and neck region. Fifty patients were included in the original study.
A total of 183 patients with recurrent or disseminated squamous cell carcinoma were eventually included in the extended study. There were 37 women and 146 men. The mean age was 56 years. Performance status (WHO) was as follows: WHO 0:31, WHO 1:107, and WHO 2:45 patients. The treatment consisted of paclitaxel 175 mg/m, once every third week and capecitabine 825 mg/m p.o. b.i.d for 2 weeks.
The overall response rate (complete response and partial response) according to the WHO criteria was: 33% (CI 26-40). The median progression-free survival was 4.8 (CI 4.2-5.4) months. The median overall survival (OS) was 8.9 (CI 7.6-9.5) months. Compliance was good. Of the 1,131 cycles, only 13% had to be administered with a reduced dose and/or postponed to a later date. Toxicity was mild and grades 3 and 4 toxicities were uncommon. Two toxic deaths were registered though.
The response rate and the OS for this low toxicity regimen makes it a feasible alternative for not cisplatin eligible patients.
本研究展示了一项扩展的II期研究结果,该研究最初发表于2007年,涉及一种含紫杉醇和卡培他滨的非铂类方案治疗复发性或播散性头颈部鳞状细胞癌的抗肿瘤活性和毒性。原始研究纳入了50名患者。
最终共有183例复发性或播散性鳞状细胞癌患者纳入了扩展研究。其中女性37例,男性146例。平均年龄为56岁。体能状态(WHO)如下:WHO 0:31例,WHO 1:107例,WHO 2:45例。治疗方案为紫杉醇175mg/m²,每三周一次,卡培他滨825mg/m²口服,每日两次,共2周。
根据WHO标准,总缓解率(完全缓解和部分缓解)为:33%(95%置信区间26%-40%)。无进展生存期的中位数为4.8(95%置信区间4.2-5.4)个月。总生存期(OS)的中位数为8.9(95%置信区间7.6-9.5)个月。依从性良好。在1131个周期中,只有13%的周期需要减少剂量和/或推迟给药。毒性较轻,3级和4级毒性不常见。不过记录到两例毒性死亡。
该低毒性方案的缓解率和总生存期使其成为不适用于顺铂治疗患者的可行替代方案。