多西紫杉醇在非小细胞肺癌二线治疗中疗效及剂量的研究

目的观察多西紫杉醇在非小细胞肺癌二线治疗中的疗效和安全性,并探讨安全使用剂量的范围。方法选取26例在2009年1月至2011年2月26日期间于福建省肿瘤医院肿瘤内科进行治疗且经病理证实符合入选标准的晚期非小细胞肺癌患者,对他们进行多西紫杉醇75mg/m2单药化疗,并根据骨髓毒性来调整剂量。每化疗2个周期后按照实体瘤疗效评价标准（RECIST1.0版）评价疗效和中位肿瘤进展时间,按照化疗药物毒副反应判定标准（NCICTC3.0版）评价毒性反应。结果 1例不能耐受其不良反应出组,1例化疗1周期后出现进展,25例病例可评价疗效。总体情况是0例CR、6例PR、13例SD、6例PD,客观有效率（RR）为24%（6/25）,疾病控制率（DCR）为76%（19/25）;中位PFS为4个月,本组中位OS为10个月。毒性主要表现为粒细胞下降及疲乏,100%粒细胞下降,其中Ⅲ/Ⅳ粒细胞下降为84.6%（22/26）;粒缺伴发热为26.9%（7/26）;Ⅲ疲乏的发生率为23.1%（6/22）。调整多西紫杉醇剂量,安全剂量浓度平均为60.84mg/m2。结论多西紫杉醇75mg/m2二线治疗晚期非小细胞肺癌骨髓毒性大,合适剂量为60mg/m2。在该剂量下,能够延长晚期非小细胞肺癌患者生存期,同时改善生活质量。

The investigation of efficacy and dosage of docetaxel as the second-line chemotherapy in non-small cell lung cancer

Objective To investigate the efficacy and toxicity of docetaxel as the second line chemotherapy in non-small cell lung cancer and to explore the appropriate dose of docetaxel. Methods Twenty- six patients with stage Ⅲ B/Ⅳ advanced non-small cell lung cancer received induction chemotherapy with two cycles of 75 mg/m 2 docetaxel, and the doseage can be adjusted according to poisoning of bone marrow. The efficacy and the median progress-free survival （PFS） was estimated by RICIST V.1.0 every two cycles, and the toxicity was estimated by progress-free. Results Out of a total of 26 patients, one patient was out because of the toxicity of docetaxel,one patient was with disease progress, 6 patients were PR, 13 patients were SD, 6 patients were PD. The objective response rate was 24% and the disease control rate was 76.The PFS was 4 months. The median overall survival（OS） was 10 months. All the patients had myelosuppression during the second line chemotherapy. The response rate of the toxicity with Ⅲ～Ⅳ degree myelosuppression was 84.6%（22/26）, with myelosuppression and fever was 26.9%（7/26）, With Ⅲ weariness was 23.1%（6/22）. The appropriate dose of docetaxel was 60mg/m 2 . Conclusion The appropriate dose of docetaxel is 60mg/m 2 ,which can improve the quality of life and prolong patients＇ life expectancy.