Paclitaxel plus Cisplatin Treatment in Non-Small-Cell Lung Cancer Patients Failing Previous Chemotherapy

太平洋紫杉醇合併順鉑使用於先前化療惡化後的非小細胞肺癌

陳育民(Yuh-Min Chen) ； 蔡俊明(Chun-Ming Tsai) ； 彭瑞鵬(Reury-Perng Perng)

《中華民國癌症醫學會雜誌》 22卷4期 (2006/12) Pp. 1-9

https://doi.org/10.6588/JCOS.2006.22.4.1

摘要

背景：我們進行使用太平洋紫杉醇合併順鉑於先前接受過化療惡化後的非小細胞肺癌病患，以評估其治療反應率與副作用。 方法：由2001年7月至2004年11月之間，共有29位病患接受治療。其中，有5位曾接受歐洲紫杉醇治療，7位曾接受順鉑治療。本次治療方式是每三週的第一天使用太平洋紫杉醇150 mg/m平方公尺加上順鉑50 mg/m平方公尺靜脈注射。 結果：所有病患均可以評估副作用與治療效果。主要的副作用是造血功能抑制。第三或第四度白血球下降，中性白血球下降，與血小板下降各自發生於5位(17.2%)、6位(20.6%)、與1位(3.4%)病患。其他副作用不多且輕微。在三個療程治療後，有5位(17.2%)病患得到局部緩解。中值生存期是7.2個月。一年存活率是44.1%。曾經使用順鉑治療的病患存活時間較未曾使用者為差（4.8個月比12.8個月，P=0.0272），曾經使用過歐洲紫杉醇的病患存活也比未曾使用的差（2.9個月比7.9個月，P=0.0417）。 結論：太平洋紫杉醇合併順鉑使用於曾經化療的非小細胞肺癌的補救性治療是有效且具一定抗癌效力，副作用又不多的治療。但是最好使用於先前未曾用過順鉑或歐洲紫杉醇的病患，例如用於第一線使用溫諾平與健擇的病患，會得到較好的結果。

並列摘要

Background We conducted a phase Ⅱ study of paclitaxel plus cisplatin chemotherapy in non-small-cell lung cancer (NSCLC) patients who had failed previous combination chemotherapy, to assess the response and toxicity of this regimen.
Methods Twenty-nine patients were enrolled from July 2001 to November 2004. Five of them had received previous docetaxel treatment, and 7 had undergone cisplatin-based treatment as a previous regimen. Treatment consisted of paclitaxel 150 mg/m^2 plus cisplatin 50 mg/m^2 intravenous infusion on day 1 of every 3 weeks.
Results All patients were evaluable for toxicity profile and response rate. The major toxicity was myelosuppression. Grade 3 or 4 leukopenia, neutropenia, and thrombocytopenia occurred in only 5 patients (17.2%), 6 patients (20.6%), and 1 patient (3.4%), respectively, during treatment. Other toxicities were few and mild in severity. After three cycles of treatment, 5 patients (17.2%) had a partial response. The median survival was 7.2 months. The one-year survival rate was 44.1%. Survival was poor in those who had been treated with cisplatin-based chemotherapy compared to non-cisplatin-based treatment (4.8 vs. 12.8 months, p=0.0272), and poorer in those who had been treated with docetaxel than in those never exposed (2.9 vs. 7.9 months, p=0.0417).
Conclusions Paclitaxel plus cisplatin salvage chemotherapy is an effective regimen with modest activity; it is well tolerated, and yields a good survival in NSCLC patients who have failed previous chemotherapy. However, it is better to use this combination in those who have never been exposed to cisplatin and/or docetaxel treatment, such as those previously treated with vinorelbine plus gemcitabine, to achieve a better survival benefit.

並列關鍵字

Cisplatin ； Non-Small-Cell Lung Cancer ； Paclitaxel ； Salvage Therapy