Weekly gemcitabine as a radiosensitiser for the treatment of brain metastases in patients with non-small cell lung cancer: phase I trial / 中华医学杂志(英文版)
Chinese Medical Journal
; (24): 458-462, 2007.
Article
in En
| WPRIM
| ID: wpr-344874
Responsible library:
WPRO
ABSTRACT
<p><b>BACKGROUND</b>Conventional treatment for non-small cell lung cancer (NSCLC) brain metastases (BM) is whole-brain radiotherapy (WBRT). The efficacy is limited. It might be increased by a potent radiosensitizer such as gemcitabine, which is believed to cross the disrupted blood-brain barrier. The primary objective of this study was to determine the maximum tolerated dose (MTD) of weekly gemcitabine given concurrently with WBRT.</p><p><b>METHODS</b>Patients with BM from NSCLC were included. The dose of WBRT was 3750 cGy (total 15 times, 3 weeks). Gemcitabine was given concurrently with WBRT on days 1, 8 and 15. The starting dose was 400 mg/m(2), escalated by 100 mg/m(2) increments. At least three patients were included per level. Dose limiting toxicity (DLT) was defined as grade 4 hematological or grade 2 neurological toxicity. When two or more patients experience DLT, the MTD was reached.</p><p><b>RESULTS</b>A total of 16 patients were included; 69% had a performance status (PS) 1 (Eastern Cooperative Oncology Group, ECOG). A total of 69% had concurrent active extra cranial diseases. All had more than 3 BM. Up to 600 mg/m(2) (level 3) no neurology toxicity was observed. At 600 mg/m(2) two out of 9 patients developed grade 4 thrombocytopenia. One of the two patients' thrombocytopenia was confused with disseminated intravascular coagulation (DIC). At 700 mg/m(2) two out of 4 patients developed neurotoxicities. One developed grade 3 seizure and cognitive disorder. Another patient developed suspected grade 2 muscle weakness.</p><p><b>CONCLUSIONS</b>The MTD was reached at a dose of 700 mg/m(2). The dose of 600 mg/m(2) would be considered for further study.</p>
Full text:
1
Database:
WPRIM
Main subject:
Pathology
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Radiation-Sensitizing Agents
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Radiotherapy
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Brain Neoplasms
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Pharmacokinetics
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Cranial Irradiation
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Carcinoma, Non-Small-Cell Lung
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Maximum Tolerated Dose
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Deoxycytidine
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Lung Neoplasms
Limits:
Aged
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Female
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Humans
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Male
Language:
En
Journal:
Chinese Medical Journal
Year:
2007
Document type:
Article