Background and objective: The combination of pacilitaxel and carboplatin has become a widely used regimen in first-line therapy of advanced NSCLC. The aim of this study is to compare the efficacy and safety of paclitaxel plus carboplatin at two dose levels in the first-line treatment of advanced NSCLC patients.
Methods: From Dec 2006 to Jun 2008, 63 patients (ECOG 0-1) with advanced NSCLC were administered with paclitaxel 175 mg/m² (42 patients) plus carboplatin (AUC 5) or paclitaxel 200 mg/m² (21 patients) plus carboplatin (AUC 5), 3-4 weeks/cycle.
Results: The objective response rate of paclitaxel 175 mg/m² group and paclitaxel 200 mg/m² group was 28.57% vs 33.33% (P=0.698); median time to progression were 6.7 months vs 7.0 months (P=0.561); median overall survival time were 18.7 months vs 19.0 months (P=0.255); one and two-year survival rate were 61.9% vs 66.7% (P=0.711) and 31.0% vs 33.3% (P=0.852), respectively. Neutropenia 3/4 grade was 61.9% vs 33.3% in paclitaxel 200 mg/m² group and paclitaxel 175 mg/m² group (P=0.031).
Conclusions: 175 mg/m² dose paclitaxel causes less neutropenia than higher dose paclitaxel. Response rate, survival rate, time to progression and survival time are not statistically significant in two groups.
背景与目的: 紫杉醇联合卡铂一线治疗晚期非小细胞肺癌（non-small cell lung cancer, NSCLC）临床应用较为广泛。本研究旨在比较不同剂量紫杉醇联合卡铂一线治疗晚期NSCLC患者的毒副反应及疗效。
方法: 2006年12月-2008年6月，共63例晚期NSCLC患者接受紫杉醇175 mg/m2或200 mg/m2联合卡铂（AUC 5）化疗，前者42例，后者21例，ECOG评分0-1分，3周-4周重复，比较两组近期和远期疗效及毒副反应。
结果: 紫杉醇175 mg/m2与200 mg/m2化疗组客观有效率分别为28.57%与33.33%（P=0.698），中位TP为6.7个月与7个月（P=0.561），MST为18.7个月与19个月（P=0.255），1年生存率为61.9%与66.7%（P=0.711），2年生存率为31%与33.3%（P=0.852）。紫杉醇200 mg/m2组3/4级中性粒细胞下降发生率明显高于175 mg/m2组，分别为61.9%与33.3%（P=0.031）。
结论: 与200 mg/m2化疗组相比，紫杉醇175 mg/m2联合卡铂一线治疗晚期NSCLC患者可明显减少3/4级中性粒细胞下降发生率，且疗效及生存期并不劣于较高剂量化疗组。