2024-03-29T14:28:45Z
https://niigata-u.repo.nii.ac.jp/oai
oai:niigata-u.repo.nii.ac.jp:00014723
2022-12-15T03:46:39Z
453:456
471:537:538:1071
Phase I Dose Escalation Study of Multicyclic, Dose-Intensive Chemotherapy with Peripheral Blood Stem Cell Support for Small Cell Lung Cancer
2)小細胞肺癌に対する末梢血幹細胞移植併用(シンポジウム 移植医療の現況, 第551回新潟医学会)
2)小細胞肺癌に対する末梢血幹細胞移植併用(シンポジウム 移植医療の現況, 第551回新潟医学会)
吉澤, 弘久
94970
松本, 尚也
94971
望月, 博史
94972
栗山, 英之
94973
各務, 博
94974
鈴木, 栄一
94975
下条, 文武
94976
Small cell lung cancer
Dose intensive chemotherapy
Granulocyte Colony-Stimulating Factor
Hematopoietic Stem Cell Transplantation
Leukapheresis
小細胞肺癌
高用量化学療法
顆粒球コロニー刺激因子
造血幹細胞移植
幹細胞採取
A phase I dose-escalation study of multicyclic, ifosfamide, carboplatin, and etoposide (ICE) with sequential reinfusion of peripheral blood stem-cells (PBSCs) was conducted to determine the maximum-tolerated dose (MTD) of ICE. Twenty-seven patients with SCLC (LD : 9, ED : 18) were treated with ifosfamide (3000-9000mg/m^2, 24-hour-infusion), carboplatin (300-400mg/m^2), and etoposide (300mg/m^2) followed by subcutaneous injection of filgrastim (75μg/day) through day 4 to the day of PBSC collection. PBSC were harvested when the WBC count reached ≧5×10^9/L. The leukapheresis product was cryopreserved and reinfused on day 4 of the next cycle, which was started 48 hours after the last PBSC collection. The ifosfamide dose was escalated as follows : 3000mg/m^2 (level 1), 5000mg/m^2 (level 2), 7000mg/m^2 (level 3), 9000mg/m^2 (level 4). Patients with LD were treated with concurrent radiotherapy at 1.5 Gy twice daily for the initial 3 weeks to a total dose of 45Gy and MTD, defined separately. Patients were evaluated for hematologic and non-hematologic toxicity, actual dose intensities, as well as response to the therapy. The maximum-tolerated dose (MTD) was defined as the dose level at which the level produced more than 5 days of grade 4 myelosuppression or non-hematologic toxicity greater than grade 3 in two thirds of the patients. For ED cases, MTD was level 4 and the recommended dose of ifosfamide was 7000mg/m^2. For LD cases, the recommended dose of ifosfamide was 5000mg/m^2. The dose limiting toxicity of multicyclic ICE was hematologic toxicity and CNS toxicity which manifested as ataxia. Tumor responses were seen in all patients, with 14 patients showing a complete response. The actual total dose-intensity at the recommended dose level was 2.2 and 1.74, for ED and LD, respectively, compared with previously reported ICE regimens. PBSC support for dose-intensive ICE regimen permitted dose escalation of ifosfamide with a mean interval of 16-17 days. We conclude this regimen is well tolerated, with acceptable hematological and non-hematological toxicity.
departmental bulletin paper
新潟医学会
2001-09
application/pdf
新潟医学会雑誌
9
115
432
437
新潟医学会雑誌
AN00182415
00290440
https://niigata-u.repo.nii.ac.jp/record/14723/files/115(9)_432-437.pdf
jpn