肺扁平上皮癌に対するネダプラチン，ドセタキセル併用投与法

摘要

目的．肺扁平上皮癌に対する，ネダプラテン（CDGP），ドセタキセル（TXT）併用療法の効果と副作用について検討した．対象と方法．対象は再化学療法5例，照射併用10例を含む32例で，術前·進行症例の臨床病期は，ⅡB期2例，ⅢA期11例，ⅢB期7例，Ⅳ期9例，再発症例は3例であった．男女比30：2，平均年齢65.3歳．CDGP，TXT各80～140mg/bodyをday1に1，000mlの補液の元に投与した．結果．計58コースが施行され，平均投与量はCDGP66.1mg/m~2，TXT65.8mg/m~2であった．奏功率は，全32例で59.4％（CR2例，PR17例），化学療法単独26例で57.7％（CR1例，PR14例），再化学療法5例で40.0％（PR2例）であった．grade3/4の副作用出現率は，白血球減少67.2％，血小板減少3.5％，嘔気·嘔吐3.1％であった．予後は，平均10.7カ月の観察期間で，死亡13例，生存19例であり，全32例での生存率は，1年67.2％，3年28.5％，非切除22例での生存率は，1年62.6％，3年11.9％であった．結語．肺扁平上皮癌に対するCDGP，TXT併用投与法は十分な耐用度と高い奏功率を示し，進行·再発症例あるいは術前治療として有用である．Objective. To evaluate the efficacy and safety of the nedaplatin (CDGP) -docetaxel (TXT) combination in patients with squamous cell lung cancer. Patients and methods. Thirty-two patients with histologically confirmed squamous cell lung cancer were treated and evaluated (2 with stage ⅡB, 11 with stage ⅢA, 7 with stage ⅢB, 9with stage Ⅳ and 3 recurrent cases). There were 30 males and 2 females and their mean age was 65.3 (42-89). Five patients received previous chemotherapy and 10 received concurrent or sequential radiotherapy. Patients received CDGP(80-140mg/body) and TXT (80-140mg/body) on day 1 with 1,000 ml hydration. Treatment was repeated every four weeks. Results. Fifty eight courses were performed for 32 patients. The mean dosage per course of CDGP and TXT were 66.1mg/m~2 (49.1-82.4) and 65.8mg/m~2 (49.1-82.4) respectively. Two complete and 17 partial responses were observed (overall response rate (OR): 59.4%). The OR was 57.7% and 40.0% in patients without radiotherapy and with previous chemotherapy respectively. Thirteen patients were dead and 19 were alive at 10.7 months mean follow up time. The 1, 2 and three-year survival rate were 67.2%, 28.5%, 28.5% for all 32 cases and 62.6%, 11.9%, 11.9% in chemotherapy alone cases. Grade 3/4 leucocytopenia and thrombocytopenia occurred in 39 courses and 2 courses respectively. Grade 3/4 nausea/vomiting was observed in only one patient and there was no grade 3 nephrotoxicity. There was no treatment-related death. Conclusions. The nedaplatin-docetaxel combination is an active and safe regimen in squamous cell lung cancers.