Choy H, Safran H
Department of Radiation Therapy, Rhode Island Hospital, Providence 02903, USA.
Semin Oncol. 1995 Aug;22(4 Suppl 9):55-7.
Paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) is an attractive agent to combine with radiation for non-small cell lung cancer. We have been conducting clinical trials of weekly paclitaxel and concurrent radiation therapy. In a phase I study in non-small cell lung cancer, we determined the maximum tolerated dose of paclitaxel to be 60 mg/m2/wk with radiation. Patients received paclitaxel 60 mg/m2/wk as a 3-hour infusion for 6 weeks with radiation to the primary tumor and regional lymph nodes (40 Gy) followed by a boost to the tumor (20 Gy). From March 1994 to February 1995, 33 patients have been entered by the Clinical Oncology Group of Rhode Island. The overall response rate (complete plus partial responses) of 25 evaluable patients as of March 1995 was 84%, with a confidence interval of 68 to 96. The major toxicity was esophagitis. Twenty percent of patients had grade 4 esophagitis. Only 8% of patients had grade 3 neutropenia. Combined-modality therapy with paclitaxel and radiation is a promising treatment for locally advanced non-small cell lung cancer with a high response rate and acceptable toxicity.
紫杉醇（泰素；百时美施贵宝公司，新泽西州普林斯顿）是一种与放疗联合用于非小细胞肺癌的有吸引力的药物。我们一直在进行每周一次紫杉醇与同步放疗的临床试验。在一项非小细胞肺癌的I期研究中，我们确定紫杉醇与放疗联合时的最大耐受剂量为60mg/m²/周。患者接受60mg/m²/周的紫杉醇，静脉输注3小时，共6周，同时对原发肿瘤和区域淋巴结进行放疗（40Gy），随后对肿瘤进行追加放疗（20Gy）。从1994年3月至1995年2月，罗德岛临床肿瘤学组共纳入了33例患者。截至1995年3月，25例可评估患者的总缓解率（完全缓解加部分缓解）为84%，置信区间为68%至96%。主要毒性为食管炎。20%的患者发生4级食管炎。只有8%的患者发生3级中性粒细胞减少。紫杉醇与放疗的联合治疗是局部晚期非小细胞肺癌一种有前景的治疗方法，缓解率高且毒性可接受。
