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A multi-center randomized controlled study of paclitaxel plus carboplatin versus oral uracil-tegafur as the adjuvant chemotherapy in resected non-small cell lung cancer
Journal of Thoracic Oncology ( IF 20.4 ) Pub Date : 2018-05-01 , DOI: 10.1016/j.jtho.2018.02.015
Shinichi Toyooka , Norihito Okumura , Hiroshige Nakamura , Masao Nakata , Motohiro Yamashita , Hirohito Tada , Shinsuke Kajiwara , Naoki Watanabe , Morihito Okada , Junichi Sakamoto , Motoi Aoe , Junichi Soh , Shinichiro Miyoshi , Katsuyuki Hotta , Keitaro Matsuo , Hiroshi Date

Introduction: We conducted a randomized controlled study to compare the survival benefit of paclitaxel plus carboplatin and oral uracil‐tegafur (UFT) as adjuvant chemotherapy in resected NSCLC. Methods: In an open‐label multicenter trial, patients with pathological stage IB to IIIA NSCLC were randomized into a group receiving paclitaxel (175 mg/m2) plus carboplatin (area under the curve 5) every 3 weeks for four cycles (arm A) or a group receiving orally administered UFT (250 mg/m2) daily for 2 years (arm B). The primary and secondary end points were overall survival and relapse‐free survival and toxicity, respectively. Results: Between November 2004 and November 2010, 402 patients from 40 institutions were included (201 in each arm). The median follow‐up period was 6.5 years. The 5‐year overall survival rate was 70% (95% confidential interval [CI]: 63–76] in arm A versus 73% (95% CI: 66–78) in arm B (hazard ratio = 0.92, 95% CI: 0.55–1.41, p = 0.69). There was no significant difference in the 5‐year relapse‐free survival rate between arms A and B (56% versus 57% [hazard ratio = 0.92, 95% CI: 0.63–1.34, p = 0.50]). Toxicities were well tolerated and there was no treatment‐related death. Toxicities of any grade or grade 4 were significantly more frequent in the paclitaxel plus carboplatin group (95.7% and 22.1%, respectively) than in the UFT group (76.5% and 1.0%, respectively [p < 0.0001 in both]). Conclusions: As adjuvant chemotherapy, paclitaxel plus carboplatin was no better than UFT in terms of survival among patients with stage IB to IIIA NSCLC tumors who underwent complete resection (UMIN000000810).

中文翻译:

紫杉醇联合卡铂与口服尿嘧啶-替加氟作为可切除非小细胞肺癌辅助化疗的多中心随机对照研究

简介:我们进行了一项随机对照研究,以比较紫杉醇加卡铂和口服尿嘧啶-替加氟 (UFT) 作为已切除 NSCLC 的辅助化疗的生存获益。方法:在一项开放标签多中心试验中,将病理分期为 IB 至 IIIA NSCLC 的患者随机分为一组接受紫杉醇(175 mg/m2)加卡铂(曲线下面积 5)每 3 周一次,共四个周期(A 组)或一组每天接受口服 UFT (250 mg/m2) 2 年(B 组)。主要和次要终点分别是总生存期、无复发生存期和毒性。结果:2004 年 11 月至 2010 年 11 月期间,共纳入来自 40 个机构的 402 名患者(每组 201 名)。中位随访期为 6.5 年。63-76] 组 A 与组 B 的 73%(95% CI:66-78)(风险比 = 0.92,95% CI:0.55-1.41,p = 0.69)。A 组和 B 组的 5 年无复发生存率没有显着差异(56% 对 57% [风险比 = 0.92,95% CI:0.63-1.34,p = 0.50])。毒性耐受性良好,没有与治疗相关的死亡。紫杉醇加卡铂组(分别为 95.7% 和 22.1%)中任何级别或 4 级的毒性显着高于 UFT 组(分别为 76.5% 和 1.0% [p < 0.0001])。结论:作为辅助化疗,紫杉醇联合卡铂在接受完全切除的 IB 至 IIIA 期 NSCLC 肿瘤患者的生存率方面并不优于 UFT(UMIN000000810)。63-76] 组 A 与组 B 的 73%(95% CI:66-78)(风险比 = 0.92,95% CI:0.55-1.41,p = 0.69)。A 组和 B 组的 5 年无复发生存率没有显着差异(56% 对 57% [风险比 = 0.92,95% CI:0.63-1.34,p = 0.50])。毒性耐受性良好,没有与治疗相关的死亡。紫杉醇加卡铂组(分别为 95.7% 和 22.1%)中任何级别或 4 级的毒性显着高于 UFT 组(分别为 76.5% 和 1.0% [p < 0.0001])。结论:作为辅助化疗,紫杉醇联合卡铂在接受完全切除的 IB 至 IIIA 期 NSCLC 肿瘤患者的生存率方面并不优于 UFT(UMIN000000810)。p = 0.69)。A 组和 B 组的 5 年无复发生存率没有显着差异(56% 对 57% [风险比 = 0.92,95% CI:0.63-1.34,p = 0.50])。毒性耐受性良好,没有与治疗相关的死亡。紫杉醇加卡铂组(分别为 95.7% 和 22.1%)中任何级别或 4 级的毒性显着高于 UFT 组(分别为 76.5% 和 1.0% [p < 0.0001])。结论:作为辅助化疗,紫杉醇联合卡铂在接受完全切除的 IB 至 IIIA 期 NSCLC 肿瘤患者的生存率方面并不优于 UFT(UMIN000000810)。p = 0.69)。A 组和 B 组的 5 年无复发生存率没有显着差异(56% 对 57% [风险比 = 0.92,95% CI:0.63-1.34,p = 0.50])。毒性耐受性良好,没有与治疗相关的死亡。紫杉醇加卡铂组(分别为 95.7% 和 22.1%)中任何级别或 4 级的毒性显着高于 UFT 组(分别为 76.5% 和 1.0% [p < 0.0001])。结论:作为辅助化疗,紫杉醇联合卡铂在接受完全切除的 IB 至 IIIA 期 NSCLC 肿瘤患者的生存率方面并不优于 UFT(UMIN000000810)。毒性耐受性良好,没有与治疗相关的死亡。紫杉醇加卡铂组(分别为 95.7% 和 22.1%)中任何级别或 4 级的毒性显着高于 UFT 组(分别为 76.5% 和 1.0% [p < 0.0001])。结论:作为辅助化疗,紫杉醇联合卡铂在接受完全切除的 IB 至 IIIA 期 NSCLC 肿瘤患者的生存率方面并不优于 UFT(UMIN000000810)。毒性耐受性良好,没有与治疗相关的死亡。紫杉醇加卡铂组(分别为 95.7% 和 22.1%)中任何级别或 4 级的毒性显着高于 UFT 组(分别为 76.5% 和 1.0% [p < 0.0001])。结论:作为辅助化疗,紫杉醇联合卡铂在接受完全切除的 IB 至 IIIA 期 NSCLC 肿瘤患者的生存率方面并不优于 UFT(UMIN000000810)。
更新日期:2018-05-01
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