第10回世界肺癌学会議(IASLC2003，バンクーバー)

学会場のカナダプレイスの夜明け：毎朝7時より早朝セミナーが開かれました．

Vancouver,　Canada- 10- 14 August, 2003

Comparative study of prophylactic Shakuyaku-Kanzou-To for myalgia/arthralgia following Carboplatin and Paclitaxel combination chemotherapy for non-small cell lung cancer

T.SAWA, T.YOSHIDA, M.SAWADA, T.ISHIGURO, M.KAWADA, T.IKOMA, Y.OHNO, K.GOTO, H.FUJIWARA
Division of Pulmonary Medicine, Gifu Municipal Hospital,
Gifu, Japan
Department of 2nd Internal Medicine, Gifu University,
Gifu, Japan

Carboplatin (CBDCA) and Paclitaxel (TXL) combination chemotherapy is one of the standard regimens for advanced non-small cell lung cancer, while myelosupression and myalgia/arthralgia are main adverse effects. Shakuyaku-Kanzou-To, a Japanese herbal medicine, is suggested to be useful to control myalgia/arthralgia induced by Paclitaxel. To evaluate the efficacy of NSAIDs and Shakuyaku-Kanzou-To combination treatment on myalgia/arthralgia, a comparative study was carried out in fifty patients with advanced or relapsed non-small cell lung cancer treated with CBADA +TXL. Patients were treated with more than 2 cycles of CBDCA (300-400mg/m<SUP>2</SUP>, or AUC5-6, day 1) + TXL (180-210mg/m<SUP>2</SUP>, day 1). Patients were assigned alternatively to two groups supported with prophylactic Shakuyaku-Kanzou-To and with only symptomatic NSAIDs. In the prophylactic Shakuyaku-Kanzou-To group, 7.5g/day of oral Shakuyaku-Kanzou-To was administered preventively through the chemotherapy. In the case of myalgia/arthralgia more than grade 2, NSAIDs was administered. Myalgia/arthralgia was classified into NCI-CTC grade and evaluated with score of grade by days.
The result was as follows.
1) Patients characteristics showed that mean age was 63.7 years old, pathological diagnosis were 32 cases of adenocarcinoma, 14 cases of squamous cell carcinoma and 4 cases of another carcinoma. In two groups, there was no difference in background of the patients.
2) Severity of myalgia/arthralgia was not significantly improved in the group with prophylactic Shakuyaku-Kanzou-To compared with the control group, while prophylactic Shakuyaku-Kanzou-To decreased score of grade by days. In the prophylactic Shakuyaku-Kanzou-To group, additional NSAIDs medication was significantly reduced.
3) Adverse effect of Shakuyaku-Kanzou-To was not observed, while hemorrhagic duodenal ulcer induced by NSAIDs was complicated in one patient.
4) Anti-tumor response showed overall response rate at 23.3% in both groups.
It is concluded that symptomatic treatment with NSAIDs and prophylactic treatment with Shakuyaku-Kanzou-To is useful to myalgia/arthralgia induced by Carboplatin and Paclitaxel combination chemotherapy.

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