Hansen H H, Dombernowsky P, Hansen M, Bork E
Department of Oncology, Finsen Institute/Rigshospitalet, Copenhagen, Denmark.
Semin Oncol. 1992 Apr;19(2 Suppl 6):65-8.
The epipodophyllotoxin derivatives teniposide and etoposide have been under clinical investigation for over 15 years. Although etoposide has been established as one of the most active compounds in the treatment of small cell lung cancer (SCLC), teniposide has received little attention. The results of seven phase II studies evaluating response rate and duration of response to teniposide in 10 previously treated and 102 untreated patients showed response rates of 21% and 58%, respectively. The most frequently used dosage schedule was 60 mg/m2 intravenously daily for 5 days every 3 weeks. The following are factors influencing the response rate and duration of response to teniposide: performance status; prior weight loss; prior chemotherapy exposure, including prior treatment with etoposide; stage; and effectiveness of prior chemotherapy, including time from last administration. Preliminary analyses from a study comparing the efficacy of teniposide with that of etoposide suggest that teniposide may be more effective in previously untreated patients with SCLC who are 70 years of age or older. The preliminary data, however, indicate that equivalent doses of teniposide cause more cases of leukopenia than etoposide. Before a final conclusion can be drawn, the results from an ongoing study using teniposide and etoposide at equitoxic doses must be evaluated.
表鬼臼毒素衍生物替尼泊苷和依托泊苷已接受临床研究超过15年。尽管依托泊苷已被确立为治疗小细胞肺癌（SCLC）最有效的化合物之一，但替尼泊苷却很少受到关注。七项II期研究评估了10例经治患者和102例初治患者对替尼泊苷的缓解率及缓解持续时间，结果显示缓解率分别为21%和58%。最常用的给药方案是每3周静脉注射60mg/m²，每日1次，共5天。以下是影响替尼泊苷缓解率和缓解持续时间的因素：体能状态；既往体重减轻情况；既往化疗史，包括既往使用依托泊苷治疗情况；分期；既往化疗疗效，包括距上次给药的时间。一项比较替尼泊苷与依托泊苷疗效的研究初步分析表明，替尼泊苷可能对70岁及以上初治SCLC患者更有效。然而，初步数据表明，同等剂量的替尼泊苷比依托泊苷导致更多白细胞减少病例。在得出最终结论之前，必须评估正在进行的使用等毒性剂量的替尼泊苷和依托泊苷的研究结果。
