Paclitaxel and Carboplatin in Combination in the Treatment of Advanced Non-small-cell Lung Cancer (NSCLC) : A Preliminary Study
VORACHAI RATANATHARATHORN, M.D.*, MANMANA JIRAJARUS, R.N., M.S.N.*, EKAPHOP SIRACHAINAN, M.D.*, SUWANNEE SIRILERTTRAKUL, R.N., M.Ed. *, ANUPARP EUAREE, M.D.*, PORNCHULEE SUPATCHAIPISIT, R.N., M.Sc.*
Affiliation : * Oncology Unit, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
Abstrad This study was aimed to detennine the activity and toxtctty of combination paclitaxel and carboplatin in stage III B and IV NSCLC. Eligibililty required performance status. Pac- litaxel was administered at a dose of 200 mgtm2, 3-hour infusion, followed by carboplatin at a tartgeted area under the concentration-time curve (AUC) of 6. Treatment was repeated at 3-week intervals for 6 courses. G-CSF 5 microgram/kg was subcutaneously injected during subsequent courses if there was grade 3-4 leukopenia or granulocytopenia in the previous course. From August 1996 through June 1997, 15 patients were enrolled. The median age was 47 years (range 20-68 years), 60 per cent were female. 73.3 per cent had adenocarcinoma, and 66.7 per cent had stage III B disease. Eighty three courses were administered; 13 patients (86. 7%) completed all six cycles. The objective response rate was 53.3 per cent, with 1 (6.7%) complete response and 7 (46.7%) partial responses. Pleural effusion, lung lesion and lymph node were the three most common sites that responded to chemotherapy. Tht: major toxicity was myelosuppression. Grade 3 or 4 granulocytopenia, anemia and thrombocytopenia were observed in 18 per cent, 7.2 per cent and 1.2 per cent, respectively, of 83 courses administered. Four episodes of febrile neutropenia (4.8%) occurred in 3 patients. There was one episode of anaphylaxis during Paclitaxel infusion. Other common toxicities were mild myalgia, paresthesias, alopecia and fatigue. Most of the toxicities showed cumulative effect. Paclitaxel plus carboplatin is a moderately active regimen in advanced NSCLC. Toxicities of this regimen are well tolerated.
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