Triplet combination of gemcitabine, paclitaxel, and carboplatin followed by maintenance 5-fluorouracil and folinic acid in patients with metastatic nasopharyngeal carcinoma
Triplet combination of gemcitabine, paclitaxel, and carboplatin followed by maintenance 5-fluorouracil and folinic acid in patients with metastatic nasopharyngeal carcinoma
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DOI：
10.1002/cncr.23687
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发表时间：
2008-09-15
期刊：
影响因子：
6.2
通讯作者：
Tan, Eng Huat
中科院分区：
文献类型：
--
作者：
Leong, Swan Swan;Wee, Joseph;Tan, Eng Huat
背景。鼻咽癌（NPC）是一种对各种化疗药物高度敏感的疾病。在转移性情况下，两种药物联合化疗通常提供 55% 至 75% 的缓解率，中位生存期为 10 至 12 个月。本研究的目的是评估 3 种药物联合治疗后进行维持治疗对转移性鼻咽癌患者的疗效。方法。转移性鼻咽癌患者每 21 天在第 1 天和第 8 天接受剂量为 1000 mg/m(2) 的吉西他滨、剂量为 70 mg/m(2) 的紫杉醇和浓度-时间曲线下面积 (AUC) 为 2.5 的卡铂联合治疗。获得部分或完全缓解的患者继续每周接受 450 mg/m(2) 剂量的 5-氟尿嘧啶和 30 mg/m(2) 剂量的亚叶酸治疗，持续 48 周。 结果。招募了二十八名患者。二十二 (79%) 名患者有 >= 2 个病变部位。毒性主要来自骨髓抑制，级别为79%。 3/4 中性粒细胞减少症、32% 3/4 级贫血和 29% 3/4 级血小板减少症（根据国家癌症研究所通用毒性标准）。 3种药物治疗方案的总体缓解率为86%，完全缓解率为11%。中位缓解持续时间为 8 个月，中位总生存期为 22 个月。结论。这种联合使用 3 种药物并随后维持治疗的方案是可行的，并且已显示出令人鼓舞的缓解率和总生存率。
BACKGROUND. Nasopharyngeal carcinoma (NPC) is a disease that is highly responsive to various chemotherapeutic agents. In the metastatic setting, 2-drug combination chemotherapy generally provides a response rate of 55% to 75%, and median survival of 10 to 12 months. The objective of the current study was to assess the efficacy of a 3-drug combination followed by maintenance treatment in patients with metastatic NPC.METHODS. Patients with metastatic NPC were treated with a combination of gemcitabine at a dose of 1000 mg/m(2), paclitaxel at a dose of 70 mg/m(2), and carboplatin at an area under the concentration-time-curve (AUC) of 2.5 on Days 1 and 8 every 21 days. Patients who achieved partial or complete response continued to receive weekly 5-fluorouracil at a close of 450 mg/m(2) and leucovorin at a dose of 30 mg/m(2) for 48 weeks.RESULTS. Twenty-eight patients were recruited. Twenty-two (79%) patients had >= 2 sites of disease. Toxicities were mainly from bone marrow suppression, with 79% grade. 3/4 neutropenia, 32% grade 3/4 anemia, and 29%, grade 3/4 thrombocytopenia (according to the National Cancer Institute Common Toxicity Criteria). The overall response rate to the 3-drug regimen was 86%, with a complete response rate of 11%. The median duration of response was 8 months and the median overall survival was 22 months.CONCLUSIONS. This regimen of a 3-drug combination followed by maintenance is feasible and has demonstrated an encouraging response rate and overall survival.