Date H, Kiura K, Ueoka H, Tabata M, Aoe M, Andou A, Shibayama T, Shimizu N
Department of Surgery II, Okayama University School of Medicine, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.
Br J Cancer. 2002 Feb 12;86(4):530-3. doi: 10.1038/sj.bjc.6600117.
We conducted a phase I/II study to investigate whether the surgical resection after induction chemotherapy with cisplatin and irinotecan was feasible and could improve the treatment outcome for patients with pathological N(2) non-small cell lung cancer. Fifteen patients with stage IIIA non-small cell lung cancer having mediastinal lymph node metastases proved by mediastinoscopy were eligible. Both cisplatin (60 mg m(-2)) and irinotecan (50 mg m(-2)) were given on days 1 and 8. Patients received two cycles of chemotherapy after 3-4 weeks interval. Induction was followed by surgical resection in 4-6 weeks. Patients who had documented tumour regression after preoperative chemotherapy received two additional cycles of chemotherapy and other patients received radiotherapy postoperatively. After the induction chemotherapy, the objective response rate was 73%. All the 15 patients received surgical resection and complete resection was achieved in 11 (73%) patients. There was no operation-related death and one death due to radiation pneumonitis during postoperative radiotherapy. The median time from entry to final analysis was 46.5 months, ranging from 22 to 68 months. The 5-year survival rate was 40% for all the 15 patients and it was 55% for the 11 patients who underwent complete resection. We conclude that the surgical resection after induction chemotherapy with cisplatin and irinotecan is feasible, and associated with low morbidity and high respectability.
我们开展了一项I/II期研究，以调查顺铂和伊立替康诱导化疗后进行手术切除是否可行，以及能否改善病理N(2)期非小细胞肺癌患者的治疗效果。15例经纵隔镜检查证实有纵隔淋巴结转移的IIIA期非小细胞肺癌患者符合条件。顺铂（60 mg m(-2)）和伊立替康（50 mg m(-2)）均在第1天和第8天给药。患者在间隔3 - 4周后接受两个周期的化疗。诱导化疗后4 - 6周进行手术切除。术前化疗后记录有肿瘤退缩的患者再接受两个周期的化疗，其他患者术后接受放疗。诱导化疗后，客观缓解率为73%。15例患者均接受了手术切除，11例（73%）患者实现了完全切除。无手术相关死亡，术后放疗期间有1例因放射性肺炎死亡。从入组到最终分析的中位时间为46.5个月，范围为22至68个月。15例患者的5年生存率为40%，接受完全切除的11例患者的5年生存率为55%。我们得出结论，顺铂和伊立替康诱导化疗后进行手术切除是可行的，且发病率低、切除率高。
