顺铂和依托泊苷交替联合异环磷酰胺、长春新碱、表柔比星治疗小细胞肺癌。
Cisplatin and etoposide alternating ifosfamide, vincristine, epirubicin in small cell lung cancer.
作者信息
Unsal Meftun, Erturk Didem
机构信息
Department of Pulmonary Medicine, Ondokuz Mayis University, Samsun, Turkey.
出版信息
Saudi Med J. 2003 Jun;24(6):628-31.
OBJECTIVE
The aim of this study was to evaluate the effects and toxicity of alternating cisplatin+etoposide (EP) and ifosfamide+vincristine+epirubicin (IVE) combination regimen in patients with small cell lung cancer (SCLC).
METHODS
We have treated 38 SCLC patients with 6 courses of alternating chemotherapy consisting of cisplatin 100 mg/m2 on day one and etoposide 80 mg /m2 on the first, second and third days in courses of first, third and fifth, alternating with ifosfamide 4 g/m2, vincristine 2 mg/day and epirubicin 60 mg/m2 intravenously on day one in courses of second, forth and sixth. The courses were administrated every 3 weeks. After the sixth course of chemotherapy the patients with limited disease (LD) who had a complete response (CR) received concomitant chest irradiation. None of the patients had prophylactic cranial irradiation. The study was conducted between January 1997 and July 1997 in the Department of Chest Disease at Ondojuz Mayis University Hospital, Samsun, Turkey.
RESULTS
The mean age of the 3 female and 35 male patients was 59.5 (33-72) years. Eighteen of which had LD and 20 had extensive disease (ED). Twenty patients had Eastern Cooperative Oncology Group (ECOG) 1 and 18 had ECOG 2 performance status. Objective response (OR) was obtained in 26 (68%) of the patients. While 13 patients had a CR rate, 6 patients remained stable (16%). The OR rate was observed to be 100% (CR 61%, partial response [PR] 39%) in patients with LD, whereas it was 40% (CR 10%, PR 30%) in patients with ED. The median survival was 9 months in LD and 6 months in ED. Relapses after CR occurred in 11 patients with LD (local relapse in 8; one in the brain; one in the liver; one in the bone) and one patient with ED (in the brain). The observed toxicities were grade III-IV leukopenia 13%, grade III-IV nausea and vomiting 8%, and 39% alopecia.
CONCLUSION
We conclude that the described regimen is a well-tolerated, less toxic therapy for SCLC.
目的
本研究旨在评估顺铂+依托泊苷（EP）与异环磷酰胺+长春新碱+表柔比星（IVE）交替联合方案对小细胞肺癌（SCLC）患者的疗效及毒性。
方法
我们对38例SCLC患者进行了6个疗程的交替化疗，在第1、3、5疗程中，第1天给予顺铂100mg/m²，第1、2、3天给予依托泊苷80mg/m²；在第2、4、6疗程中，第1天静脉给予异环磷酰胺4g/m²、长春新碱2mg/天和表柔比星60mg/m²。疗程每3周进行一次。在第6疗程化疗后，对达到完全缓解（CR）的局限性疾病（LD）患者进行同步胸部放疗。所有患者均未接受预防性颅脑照射。本研究于1997年1月至1997年7月在土耳其萨姆松市翁多朱兹马伊斯大学医院胸科进行。
结果
38例患者中，3例女性，35例男性，平均年龄59.5岁（33 - 72岁）。其中18例为LD，20例为广泛期疾病（ED）。20例患者东部肿瘤协作组（ECOG）体能状态评分为1分，18例为2分。26例（68%）患者获得客观缓解（OR）。13例患者达到CR，6例病情稳定（16%）。LD患者的OR率为100%（CR 61%，部分缓解[PR] 39%），而ED患者的OR率为40%（CR 10%，PR 30%）。LD患者的中位生存期为9个月，ED患者为6个月。11例LD患者在CR后复发（8例局部复发；1例脑转移；1例肝转移；1例骨转移），1例ED患者复发（脑转移）。观察到的毒性反应为III - IV级白细胞减少13%，III - IV级恶心呕吐8%，脱发39%。
结论
我们得出结论，所描述的方案对SCLC是一种耐受性良好、毒性较小的治疗方法。
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