Paclitaxel liposome combined with cisplatin chemotherapy in non-small cell lung cancer with brain metastasis

Abstract

Objective To evaluate the clinical efficacy and toxicity of paclitaxel liposome combined with cisplatin chemotherapy in NSCLC with brain metastasis. Methods Twenty-eight patients were newly diagnosed NSCLC with brain metastasis (confirmed by pathology or cytology). The patients were treated with paclitaxel liposome (135 mg/m2) on day 1 intravenous drip for 3 hours, cisplatin, 25 mg/m2 on day 1-3. The course of treatment was 21 days. The patients accepted the anti-allergy treatment before chemotherapy. Results Twenty-eight patients could be evaluated, and 101 treatment cycles were completed (3.6 cycles per patient). General lesion assessment presented that no patient got complete remission (CR), 13 patients (46.43%) got a partial response (PR), 11 (39.28%) had a stable disease(SD) and 4 (14.29%) had a progressive disease (PD). The objective response rate (RR) was 46.43%, and the disease control rate (DCR) was 85.71%. Local cerebral response assessment showed that no patient got CR, 6 patients (21.43%) got a PR, 15 (53.58%) had a SD and 4 (14.29%) had a PD. The RR was 21.43%, and the DCR was 85.71%. There was a significant difference in the RR (χ2=3.90, P=0.03) but not in the DCR (χ2=0.15, P=0.3) between the local cerebral disease and the general lesion. The median time to disease progression (TTP) for general lesion and local cerebral were 7.2 months and 6.2 months, respectively (χ2=6.43, P<0.05). The adverse reactions included bone marrow suppression, gastrointestinal reactions, elevated transaminases, alopecia, neurotoxicity, etc. All of these could be well controlled. Conclusion Paclitaxel liposome combined with cisplatin regimen demonstrates a higher efficacy and well tolerable against main metastasis of NSCLC, and the adverse effects are minor. Key words: Lung neoplasms; Neoplasm metastasis; Cisplatin; Paclitaxel liposome