Objective To assess the efficacy, safety and dosage regimen of docetaxel in patients with non small cell lung cancer (NSCLC).
Methods We searched The Cochrane Library, MEDLINE, EMBASE, CBM, CNKI, VIP and etc to collect controlled trials which involved docetaxel as the second-line treatment of NSCLC. Two reviewers evaluated the quality of included trials independently. The Cochrane Collaboration’s software RevMan 4.2 was used for meta-analyses.
Results Eight randomized controlled trials were included, all of which didn’t mention the blinding methods. Compared with best supportive care (BSC), the docetaxel group showed longer time to progression (10.6 vs. 6.7 weeks, P lt;0.001) and longer median survival (7.0 vs. 4.6 months, P=0.047), as well as greater 1-year survival (37% vs. 11%, P=0.003). Patients treated with docetaxel showed higher incidence of hematologic toxicity than those treated with BSC. Meta-analyses of different docetaxel dosage regimens (1-week vs. 3-week) showed that there were no statistical differences in terms of disease control rate, response rate or 1-year survival; but the incidence of hematologic toxicity of 1-week regimen was lower than that of 3-week regimen, and no statistical difference was noted in the incidence of non-hematologic toxicity between the two regimens.
Conclusion Docetaxel as the second-line chemotherapy for NSCLC significantly improved survival compared with BSC. Two dosage regimens of docetaxel had no difference in efficacy, but some differences in hematologic toxicity. Thus, if serious hematologic toxicity occurs, the 3-week treatment regimen of docetaxel could be replaced by 1-week treatment regimen.
Citation：
GUO Rongrong,XU Fenghua,SUN Huayan. Docetaxel as a Second-line Treatment for Patients with Advanced Non Small Cell Lung Cancer: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2008, 08(10): 861-868. doi: 10.7507/1672-2531.20080191
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Copyright © the editorial department of Chinese Journal of Evidence-Based Medicine of West China Medical Publisher. All rights reserved
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潘宏铭, 徐农, 耿宝琴. 肿瘤内科诊治的策略. 第1版. 上海: 上海科 学技术出版社, 2002, 45-46.
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Gervais R, Ducolone A, Breton JL, et al. Phase II randomised trial comparing docetaxel given every 3 weeks with weekly schedule as second-line therapy in patients with advanced non-small-cell lung cancer (NSCLC). Ann Oncol, 2005, 16(1): 90-96.
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Lai CL, Tsai CM, Chiu CH, et al. Phase II randomized trial of tri-weekly versus days 1 and 8 weekly docetaxel as a second-line treatment of advanced non-small cell lung cancer. Jpn J Clin Oncol, 2005, 35(12): 700-6. Epub 2005 Nov 22.
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Camps C, Massuti B, Jiménez A, et al. Randomized phase III study of 3-weekly versus weekly docetaxel in pretreated advanced nonsmall- cell lung cancer: a Spanish Lung Cancer Group trial. Ann Oncol, 2006, 17(3): 467-472. Epub 2005 Dec 21.
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Chen YM, Shih JF, Perng RP, et al. A randomized trial of different docetaxel schedules in non-small cell lung cancer patients who failed previous platinum-based chemotherapy. Chest, 2006, 129(4): 1031-1038.
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- 1. 潘宏铭, 徐农, 耿宝琴. 肿瘤内科诊治的策略. 第1版. 上海: 上海科 学技术出版社, 2002, 45-46.
- 2. Shepherd FA, Dancey J, Ramlau R, et al. Prospective randomized trial of docetaxel versus best supportive care in patients with nonsmall- cell lung cancer previously treated with platinum-based chemotherapy. J Clin Oncol, 2000, 18(10): 2095-2103.
- 3. Dancey J, Shepherd FA, Gralla RJ, et al. Quality of life assessment of second-line docetaxel versus best supportive care in patients with non-small-cell lung cancer previously treated with platinum-based chemotherapy: results of a prospective, randomized phase III trial. Lung Cancer, 2004, 43(2): 183-194.
- 4. Fossella FV, DeVore R, Kerr RN, et al. Randomized phase III trial of docetaxel versus vinorelbine or ifosfamide in patients with advanced non-small-cell lung cancer previously treated with platinumcontaining chemotherapy regimens. The TAX 320 Non-Small Cell Lung Cancer Study Group. J Clin Oncol, 2000, 18(12): 2354-2362.
- 5. Gridelli C, Gallo C, Di Maio M, et al. A randomised clinical trial of two docetaxel regimens (weekly vs 3 week) in the second-line treatment of non-small-cell lung cancer. The DISTAL 01 study. Br J Cancer, 2004, 91(12): 1996-2004.
- 6. Gervais R, Ducolone A, Breton JL, et al. Phase II randomised trial comparing docetaxel given every 3 weeks with weekly schedule as second-line therapy in patients with advanced non-small-cell lung cancer (NSCLC). Ann Oncol, 2005, 16(1): 90-96.
- 7. Lai CL, Tsai CM, Chiu CH, et al. Phase II randomized trial of tri-weekly versus days 1 and 8 weekly docetaxel as a second-line treatment of advanced non-small cell lung cancer. Jpn J Clin Oncol, 2005, 35(12): 700-6. Epub 2005 Nov 22.
- 8. Camps C, Massuti B, Jiménez A, et al. Randomized phase III study of 3-weekly versus weekly docetaxel in pretreated advanced nonsmall- cell lung cancer: a Spanish Lung Cancer Group trial. Ann Oncol, 2006, 17(3): 467-472. Epub 2005 Dec 21.
- 9. Chen YM, Shih JF, Perng RP, et al. A randomized trial of different docetaxel schedules in non-small cell lung cancer patients who failed previous platinum-based chemotherapy. Chest, 2006, 129(4): 1031-1038.
