Gatzemeier U, von Pawel J, Laumen R, Hossfeld D K, Neuhauss R, Reck M, Lenaz L
Department of Thoracic Oncology, Grosshansdorf Hospital, FRG.
Oncology. 1992;49 Suppl 1:25-33. doi: 10.1159/000227107.
Carboplatin is one of the most active agents in untreated small cell lung cancer (SCLC; 14% complete response, CR; and 61% CR + partial response, PR). The combination carboplatin/etoposide/vincristine (CEV) (phase II trial) led to an overall remission rate of 84% in patients with limited disease, with 52% CR. The median survival time with this combination was 13 months in patients with limited disease and 9.5 months in those with extensive disease. The 4-year survival rates are 26% in limited disease and 8% in extensive disease, with a plateau of the survival curve. This regimen is highly effective and exhibits low toxicity in SCLC. To evaluate the role of carboplatin in combination chemotherapy in patients with extensive SCLC, a phase III trial was performed. In this ongoing trial comparing CEV and etoposide/vincristine in SCLC patients with extensive disease, CR and overall response rates are higher in the CEV arm (CR 32 vs. 17%, CR + PR 80 vs. 60%), with statistically significant difference. In summary, chemotherapy regimens containing platinum compounds are among the most active in the treatment of SCLC. The use of the new compound carboplatin instead of cisplatin has led to similar or increased remission rates and is preferable because it has fewer side effects. Preliminary results from this ongoing, prospective, randomized phase III trial will be presented.
卡铂是未治疗的小细胞肺癌（SCLC）中活性最高的药物之一（完全缓解率为14%，完全缓解率加部分缓解率为61%）。卡铂/依托泊苷/长春新碱联合方案（CEV，II期试验）使局限性疾病患者的总缓解率达到84%，完全缓解率为52%。该联合方案治疗局限性疾病患者的中位生存时间为13个月，广泛性疾病患者为9.5个月。局限性疾病患者的4年生存率为26%，广泛性疾病患者为8%，生存曲线出现平台期。该方案在SCLC中高效且毒性低。为评估卡铂在广泛性SCLC患者联合化疗中的作用，进行了一项III期试验。在这项正在进行的比较CEV和依托泊苷/长春新碱治疗广泛性疾病SCLC患者的试验中，CEV组的完全缓解率和总缓解率更高（完全缓解率分别为32%对17%，完全缓解率加部分缓解率分别为80%对60%），差异具有统计学意义。总之，含铂化合物的化疗方案是治疗SCLC最有效的方案之一。使用新化合物卡铂而非顺铂可使缓解率相似或提高，且因其副作用较少而更可取。将展示这项正在进行的前瞻性随机III期试验的初步结果。
