周剂量紫杉类预处理方案的临床研究——紫杉类与铂类药物联合治疗晚期非小细胞肺癌

A clinical study on the pre-medication of weekly paclitaxel/docetaxel: effect of paclitaxel/docetaxel combining with cisplatin/oxaliplatin in the treatment of non-small cell lung cancer

目的:观察几种周剂量紫杉类化疗预处理方案的安全性以及不良反应,探索最佳周剂量紫杉类预处理方法。方法:紫杉醇50～65 mg.m-2静脉滴注>3 h,第1天,每周1次,连续2～3周,联合铂类,28 d重复(17例)。多西紫杉醇60 mg静脉滴注1 h,第1、8、15天,联合顺铂60～90 mg.m-2,28 d重复(9例)。采用多种预处理方式。结果:预处理相关的毒副反应包括过敏性反应1例,低钾血症5例,肌无力2例,呃逆1例,水钠潴留2例,感染2例。结论:我们推荐的周剂量紫杉类化疗预处理方案为:(1)使用紫杉醇前12及2 h,口服地塞米松2.25～7.5 mg;(2)使用多西紫杉醇前1 d、当日和第2天口服地塞米松4.5～7.5 mg,每日2次。均于化疗前30 min予止吐药、H2受体拮抗剂和抗组胺药。

Objective To study the safety and adverse reactiones of the pre-medication for weekly paclitaxel/ docetaxel chemotherapy on non-small cell lung cancer, and investigate optimal pre-medication methods. Methods 17 cases were treated with paclitaxel 50 -65 mg·m^-2 every week combining platinum,9 cases with docetaxel 60 mg every week combining cisplatin. Each cycle consisted of two or three consecutive weekly taxane followed by 1 week rest. Four pre-medications were attempted. Result hypopotassemia （5 cases） , myasthenia（2 The adverse reactions of pre-medications included ： hypersensitivity （ 1 case）, cases）, hiccup （ 1 case ）, retention of water and sodium （ 2 cases）, infection （ 2 cases）. Conclusions Our recommendations for weekly taxane pre-medication are the following： dexamethasone 2.25 - 7.5 mg orally 12 h and 2 h before paclitaxel, antihistaminic and an H2-blocker 30 min before paclitaxel; dexamethasone 4.5 -7.5 mg bid ,orally for three consecutive days （ d - 1 ,d 0 and d 2） ,antihistaminic and an H2-blocker 30 min before docetaxel.