A Pilot Study of Taxol Treatment in Carcinoma of Unknown Primary Site: Preliminary Results

Taxol治療原發部位不明的癌症（不明癌）之前導性研究：初報

陳榮楷(Wing-Kai Chan) ； 林增熙(Tzeng-Hsi Lin) ； 劉敏(Ming Liu) ； 陳育民(Yuh-Min Chen) ； 吳銘芳(Ming-Fung Wu) ； 彭汪嘉康(Jacqueline Whang-Peng)

《放射治療與腫瘤學》 1卷3期 (1994/09) Pp. 217-227

https://doi.org/10.6316/TRO/199401(3)217

摘要

原發部位不明的癌症（不明癌）併有廣泛肝轉移的預後非常差。近十年，在抗癌藥物的發展上，Taxol是最有展望的其中之一。然而Taxol對不明癌的抗癌效果，日前仍屬未知。此前導性研究的目的在探討Taxol治療不明癌的可行性。研究方法是選擇不明癌併肝轉移病患以每3星期為一療程，給予Taxol每平方公尺體表面積175毫克靜脈注射3小時，並評估治療反應及毒性反應。結果，共有3位病人，前2位曾接受過化學治療及放射治療。第1位患者對Taxol有部份緩解反應，耐受度相當好且劑量在不依靠任何白血球刺激生長因子之下，可提高到每平方公尺體表面積230毫克。第2位患者本身是B型肝炎帶原者，他只接受過一個療程目前尚待評估治療反應，但對Taxol治療的耐受性相當好。整個來說，Taxol引起的毒性反應是相當可忍受的，主要毒性是骨髓抑制，劑量限制的毒性在首位患者是肌肉疼痛。無厭食、嘔吐、肝腎毒性、心律不整或過敏反應。
結論，此前導性研究的初報提示：用Taxol治療曾經化學治療或放射治療且併肝轉移的不明癌，以3星期為一療程，使用每平方公尺體表面積175毫克，3小時靜脈注射方式，是可行的，此治療不僅耐受性相當好，而且首位患者更是第一位被報告使用Taxol治療頑固性不明癌有效的病例。

關鍵字

Taxol ； 原發部位不明的癌症

並列摘要

Background: Patients with carcinoma of unknown primary site (CUPS) and massive liver metastasis have a poor prognosis. Taxol is one of the most promising anticancer agent developed in the last decade. The anticancer activity of Taxol in CUPS is unknown. The objective of this pilot study is to investigate the feasibility of Taxol treatment in CUPS.
Method: Patients with CUPS with massive liver metastases were eligible. Taxol 175 mg/m^2 was administered by 3-hour intravenous infusion every three weeks. Patients were evaluated for response and toxicity.
Results: Three patients were studied. The first two patients had failed previous chemotherapy and radiotherapy. The first patient had partial response to Taxol therapy. He tolerated Taxol well. Taxol was escalated to 230 mg/m^2 without G.CSF support. The second patient, a hepatitis B carrier, received one course of Taxol treatment and had stable disease. He tolerated treatment well but developed reactivation of hepatitis B virus with ful-minant hepatitis. The third patient tolerated treatment well but response was too early to be evaluated. The overall toxicities of Taxol treatment were tolerable. The major toxicity was myelosuppression. The dose-limiting toxicity was myalgia in one patient. No nausea, vomiting, major organ toxicity, hypersensitivity reaction or heart block was noted.
Conclusions: The preliminary results of this pilot study suggest that it is feasible to administer Taxol with full dose of 175 mg/m^2 in 3-hour intravenous infusion every 3 weeks to CUPS patients. Taxol treatment was well tolerated. The anticancer response observed in this study was the first report of effectiveness of taxol in the treatment of CUPS patient with massive liver metastases, and refractory to chemotherapy and radiotherapy.

並列關鍵字

Taxol ； Carcinoma of Unknown Primary Site