Choy H, Browne M J
Department of Radiation Therapy, Rhode Island Hospital, Providence 02903, USA.
Semin Oncol. 1995 Jun;22(3 Suppl 6):70-4.
The new anticancer agent paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) has demonstrated in vitro radiation-sensitizing effects. In this phase I study, paclitaxel in escalating doses was administered weekly with concurrent radiation therapy to patients with regionally advanced non-small cell lung cancer (NSCLC). The goal was to determine the maximum tolerated dose of paclitaxel in this combination, to identify toxicities, and to evaluate response. Twenty-seven patients with NSCLC were enrolled into a phase I trial of concurrent paclitaxel and radiation therapy administered as a 3-hour infusion each week for 6 weeks. The paclitaxel doses ranged from 10 to 70 mg/m2/wk. Radiation therapy was delivered with weekly paclitaxel as 40 Gy in 20 fractions to the original volume with a boost of 20 Gy in 10 fractions to the primary tumor. Esophagitis was the dose-limiting toxicity at a maximum tolerated dose of 60 mg/m2/wk. The combination of concurrent radiation therapy and weekly outpatient paclitaxel can be safely delivered to patients with NSCLC at a dose of 60 mg/m2. Esophagitis appeared to be the dose-limiting toxicity. A phase II study of concurrent paclitaxel and radiation therapy is under way.
新型抗癌药物紫杉醇（泰素；百时美施贵宝公司，新泽西州普林斯顿）已在体外显示出放射增敏作用。在这项I期研究中，对局部晚期非小细胞肺癌（NSCLC）患者每周给予递增剂量的紫杉醇并同时进行放射治疗。目的是确定该联合方案中紫杉醇的最大耐受剂量，识别毒性，并评估疗效。27例NSCLC患者入组一项I期试验，该试验将紫杉醇与放射治疗同时进行，每周静脉输注3小时，共6周。紫杉醇剂量范围为10至70mg/m²/周。放射治疗与每周的紫杉醇同时进行，对初始体积给予40Gy分20次照射，对原发肿瘤给予20Gy分10次的追加照射。食管炎是最大耐受剂量为60mg/m²/周时的剂量限制性毒性。放射治疗与每周门诊给予紫杉醇的联合方案能够以60mg/m²的剂量安全地应用于NSCLC患者。食管炎似乎是剂量限制性毒性。一项紫杉醇与放射治疗同时进行的II期研究正在开展。
