Ettinger D S
Department of Oncology and Medicine, The Johns Hopkins Oncology Center, Baltimore, MD 21287, USA.
Semin Radiat Oncol. 1999 Apr;9(2 Suppl 1):148-50.
Therapy for limited-disease (LD) small cell lung cancer (SCLC) includes combined modality therapy using radiation (XRT) and systemic chemotherapy. Because such therapy is effective in treating the disease, LD SCLC is now considered potentially curable. Based on data from the Intergroup study, the current standard chemotherapy regimen is etoposide plus either cisplatin or carboplatin administered concomitantly with XRT given once or twice daily. Paclitaxel has demonstrated efficacy in the treatment of extensive-disease (ED) SCLC and in vitro data suggest that the agent has significant radiosensitizing potential. The Sarah Cannon Cancer Center, Nashville, TN, recently reported the results of two sequential phase II studies evaluating two paclitaxel doses in combination with cisplatin and etoposide for SCLC; patients with LD SCLC also received XRT. Patients with LD SCLC demonstrated a higher overall response rate to the higher-dose regimen; median survival was 17 months with the lower-dose regimen and more than 16 months with the higher-dose regimen. Three additional studies are under way to further evaluate the role of paclitaxel in combination with cisplatin, etoposide, and XRT therapy for the treatment of LD SCLC. Although the number of evaluable patients is limited and all studies are ongoing, preliminary results thus far appear encouraging.
局限期（LD）小细胞肺癌（SCLC）的治疗包括采用放疗（XRT）和全身化疗的综合治疗模式。由于这种治疗方法对治疗该疾病有效，LD SCLC现在被认为有潜在治愈可能。根据组间研究的数据，目前的标准化疗方案是依托泊苷加顺铂或卡铂，并与每天一次或两次的XRT同步给药。紫杉醇已证明对广泛期（ED）SCLC有效，体外数据表明该药物具有显著的放射增敏潜力。田纳西州纳什维尔的莎拉·坎农癌症中心最近报告了两项序贯II期研究的结果，该研究评估了两种紫杉醇剂量联合顺铂和依托泊苷用于SCLC的疗效；LD SCLC患者也接受了XRT。LD SCLC患者对高剂量方案的总体缓解率更高；低剂量方案的中位生存期为17个月，高剂量方案的中位生存期超过16个月。另外三项研究正在进行中，以进一步评估紫杉醇联合顺铂、依托泊苷和XRT治疗LD SCLC的作用。尽管可评估患者数量有限且所有研究仍在进行中，但迄今为止的初步结果似乎令人鼓舞。
