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UFT连续口服与顺铂分两次给药联合应用于非小细胞肺癌的初步试验

Pilot trial of a combination comprising of consecutive oral administration of UFT, and two-divided administration of CDDP in non-small cell lung cancer.

作者信息

Gemma A, Kudoh S, Yoshimura A, Ono Y, Takenaka K, Hayashihara K, Hino M, Shibuya M, Niitani H

机构信息

Fourth Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.

出版信息

Anticancer Res. 1995 Nov-Dec;15(6B):2691-5.

PMID:8669849
Abstract

A pilot study of a combination therapy comprising of consecutive oral administration of UFT, and two-part divided administration of CDDP was undertaken in patients with inoperative non-small cell lung cancer, based on the synergistic effects of CDDP and 5FU. UFT was administered orally at a dosage of 400 mg/m2 for two consecutive weeks (Day 1-Day 14) and CDDP was administered twice by intravenous infusion, once on Day 4 and again on Day 8. The unit dose of CDDP was increased sequentially, from 40 mg/m2 in step 1, to 50 mg/m2 in step 2, and then to 60 mg/m2 in step 3, with safety being confirmed during the process. The numbers of patients registered for each dose level were 3, 3, and 20, respectively. Evaluation of toxicities could be conducted for all the patients except one. No toxicities of grade 3 or higher were observed in step 1 or 2. There was no problem with continuous administration of UFT. The following toxicities of grade 3 or higher were observed in step 3: leukocytopenia in 2 patients; reduction of the hemoglobin count in 1; decrease in creatinine clearance in 2; anorexia in 3; and nausea and vomiting in 3. Bone marrow suppression was mild and transient. Renal failure and digestive symptoms, which were proved to be transient and treatable by symptomatic treatment, were also observed. The step 3 administration was effective in 8 (47.1%) of the 17 patients with measurable lesions (95% CI: 23-71%). In conclusion, since it was determined that the dose employed in step 3 should be recommended and that it could be expected to exhibit antitumour effects with mild bone-marrow suppression, a large scale phase II study should be conducted in no prior treatment non-small cell lung cancer.

摘要

基于顺铂(CDDP)和5-氟尿嘧啶(5FU)的协同作用,对无法手术的非小细胞肺癌患者进行了一项联合治疗的初步研究,该联合治疗包括连续口服优福定(UFT)以及分两部分给药的顺铂。优福定以400mg/m²的剂量连续口服两周(第1天至第14天),顺铂通过静脉输注给药两次,一次在第4天,一次在第8天。顺铂的单位剂量依次递增,从第1阶段的40mg/m²增至第2阶段的50mg/m²,然后在第3阶段增至60mg/m²,在此过程中安全性得到确认。每个剂量水平登记的患者人数分别为3例、3例和20例。除1例患者外,所有患者均可进行毒性评估。在第1阶段或第2阶段未观察到3级或更高等级的毒性。优福定的连续给药没有问题。在第3阶段观察到以下3级或更高等级的毒性:2例患者出现白细胞减少;1例血红蛋白计数降低;2例肌酐清除率下降;3例患者出现厌食;3例患者出现恶心和呕吐。骨髓抑制轻微且短暂。还观察到肾衰竭和消化症状,经对症治疗证明是短暂且可治疗的。在17例有可测量病变的患者中,第3阶段给药对8例(47.1%)有效(95%置信区间:23 - 71%)。总之,由于确定应推荐第3阶段使用的剂量,并且预计其可在轻度骨髓抑制的情况下发挥抗肿瘤作用,因此应在未接受过治疗的非小细胞肺癌患者中进行大规模的II期研究。

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