Abstract: ObjectiveTo explore the changes in the efficacy and adverse events of docetaxel （DTX） after adjusting dose according to the plasma concentration in advanced nonsmall cell lung cancer（NSCLC）. 
MethodsA total of 100 advanced NSCLC patients from October 2015 to April 2017 were enrolled and given DTX+carboplatin regimen as the firstline chemotherapy. The dose of DTX for the first cycle was 75 mg／m2， and then patients were divided into conventional group and experimental group according to area under the plasma drug concentrationstime curve （AUC） and the degree of myelosuppression. Patients of AUC ranging from 25 to 37 mg·h／L were assigned into conventional group， and patients of AUC ＜25 or ＞37 mg·h／L and myelosuppression were assigned to experimental group. The DTX dose in conventional group was given at 75 mg／m2 in subsequent cycles. And the dose in experimental group was adjusted according to the AUC and the degree of myelosuppression in the previous cycle. 
ResultsIn conventional group， there were 16 cases in PR， 21 cases in SD， and 13 cases in PD. The response rate （RR） was 320％， the disease control rate was 740％， and the median progressionfree survival（PFS） was 55 months. In experimental group， there were 19 cases in PR， 18 cases in SD， and 13 cases in PD. The RR and DCR were 380％ and 740％， and the median PFS was 58 months. The differences of RR， DCR and median PFS between the two groups had no differences （P＞005）. The average AUC ranged 3133（mg·h／L） in conventional group. The dose of DTX was reduced by 25％ due to myelosuppression in 2 patients at the fourth cycle. In experimental group， 35 patients had 15％ DTX dose reduction， 8 patients had 20％ reduction and 7 patients had 30％ reduction at the second cycle； 5 patients had 15％ reduction and 1 patient had 25％ reduction at the third cycle. With the adjustment of DTX， the average of AUC decreased. The average AUC at the fourth cycle was 30， lower than 33 of conventional group （P＜005）. The occurrence of myelosuppression in conventional group rose with the increase of chemotherapy cycles， while that in experimental group decreased with the increase of chemotherapy cycles and decrease of AUC. The occurrence of myelosuppression in experimental group was 162％， much lower than 649％ of conventional group （P＜0001）. 
ConclusionBy adjusting the DTX dose based on plasma concentration for NSCLC， the efficacy is equal to conventional treatment with less adverse events， which is worthy of clinical application.

Key words: Nonsmall cell lung cancer （NSCLC）, Docetaxel, Plasma concentration, Chemotherapy