高剂量表柔比星和依托泊苷治疗晚期非小细胞肺癌的II期研究。

Phase II study of high-dose epirubicin and etoposide in advanced non-small cell lung cancer.

作者信息

Smit E F, Piers D A, Postmus P E

机构信息

Department of Internal Medicine, Martini Hospital, Groningen, The Netherlands.

出版信息

Eur J Cancer. 1992;28A(12):1965-7. doi: 10.1016/0959-8049(92)90238-w.

DOI:10.1016/0959-8049(92)90238-w

PMID:1329882

Abstract

25 consecutive patients with advanced non-small cell lung cancer (NSCLC) were treated with high-dose epirubicin (HDE) 135 mg/m2 and etoposide 60 mg/m2 (days 1-3) every 3 weeks. 121 courses, (median 6, range 1-7), were administered and evaluable for toxicity: WHO grades III/IV leukocytopenia in 60/36 (80%) courses, thrombocytopenia in 18/6 (20%) and grades II/III anaemia in 31/6 (31%). Median (range) left ventricular ejection fraction (LVEF) fell from 63% (53-73, n = 25) to 60% (48-73 n = 16) after 5 courses (P < 0.02). 2 patients had a drop of more than 15% in LVEF with an epirubicin dose of 675 mg/m2. Apart from 1 patient who had tachycardia 6 months after the last course, no patient had congestive heart failure. There were 2 complete and 7 partial responses [total 9/25 (36%, 95% confidence interval: 18-57.5%)]. Median survival is 31.8 (4.3-75) weeks. Combination HDE and etoposide in NSCLC offers no advantage over HDE alone and is more toxic.

摘要

25例晚期非小细胞肺癌（NSCLC）患者每3周接受一次高剂量表柔比星（HDE）135mg/m²和依托泊苷60mg/m²（第1 - 3天）治疗。共进行了121个疗程（中位数为6，范围1 - 7），并对毒性进行了评估：世界卫生组织（WHO）III/IV级白细胞减少在60/36（80%）个疗程中出现，血小板减少在18/6（20%）个疗程中出现，II/III级贫血在31/6（31%）个疗程中出现。5个疗程后，左心室射血分数（LVEF）中位数（范围）从63%（53 - 73，n = 25）降至60%（48 - 73，n = 16）（P < 0.02）。2例患者在表柔比星剂量为675mg/m²时LVEF下降超过15%。除1例患者在最后一个疗程后6个月出现心动过速外，无患者发生充血性心力衰竭。有2例完全缓解和7例部分缓解[共9/25（36%），95%置信区间：18 - 57.5%]。中位生存期为31.8（4.3 - 75）周。NSCLC中HDE与依托泊苷联合使用并不比单独使用HDE更具优势，且毒性更大。