| Summary: | 碩士 === 國立臺灣大學 === 臨床藥學研究所 === 92 === Lung cancer is one of the most frequently diagnosed malignant diseases, and one of those that lead to the most cancer related deaths. Ever since the beneficial effect of cisplatin-based chemotherapy was demonstrated in patients of non-small cell lung cancer, chemotherapy has been widely used for advanced NSCLC. With the widespread use of chemotherapy, patients requiring second line chemotherapy have increased. Docetaxel (Taxotere®, Aventis Pharma ) is a taxane derivative with single-agent activity against NSCLC; it is the first agent approved by the FDA for second-line chemotherapy of NSCLC. However, conventional dosing of docetaxel is associated with a high incidence of acute toxicity; results from several studies have suggested that weekly low-dose administration of docetaxel reduced acute toxicity, with cumulative toxicities becoming apparent.
This retrospective study was conducted to review the use of weekly docetaxel for NSCLC in a single tertiary medical center, and to identify risk factors for selected toxicity events. A total of 155 patients with previously treated NSCLC undertaking weekly docetaxel monotherapy for were included into analysis. Related risk factors were identified: severe leukopenia or neutropenia were predicted by initial dose, leukopenia in previous chemotherapy, low baseline leukocyte counts, chronic HBV or HCV infection, and age above 70 years. Elevated ALT levels increased the risk of fluid retention that requires treatment, while previous surgery, intravenous steroids, and increase of albumin levels decreased the risk. Increased cisplatin cumulative dose and baseline leukocytosis increased the risk of moderate to severe asthenia, while longer infusion time and previous surgery decreased the risk. Chronic HBV or HCV infection and previous chemotherapy with anthracyclines are predictive of treatment withdrawal due to any adverse event; baseline leukocytosis and higher gemcitabine cumulative dose were predictive of treatment-related death.
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