Miyamoto H, Nakabayashi T, Isobe H, Akita H, Kawakami Y, Arimoto T, Asakawa M, Suzuki A, Fujikane T, Shimizu T
First Department of Medicine, Hokkaido University, Sapporo, Japan.
Oncology. 1992;49(6):431-5. doi: 10.1159/000227087.
A total of 92 patients with small-cell lung cancer (SCLC) were randomized to receive cisplatin (80 mg/m2, day 1)/etoposide (100 mg/m2, days 1, 3, 5) (PE) or cisplatin (80 mg/m2, day 1)/etoposide (100 mg/m2, days 1, 3, 5)/ifosfamide (2 g/m2, days 1, 2, 3) (PEI) combination chemotherapy. After 2 courses of chemotherapy, patients with limited disease (LD) received chest irradiation of 40-50 Gy. Of the 89 patients who could be wholly evaluated, the overall response rate was 78% for PE and 74% for PEI therapy (NS). For all patients the complete response (CR) rates were 14 versus 21%, respectively, and 22 versus 30% for LD. However, the median survival times for all patients were 55 weeks for PE therapy versus 56 weeks for PEI therapy (NS). The 2-year survival rates were 15 and 17%, respectively, for all patients (NS). There was no difference in the duration of response between PE and PEI therapy in cases with CR or partial response. However, severe leukopenia (< 2,000/mm3) occurred more often after PEI (73%) than after PE (44%) therapy (p < 0.05). These results suggest that PEI is not superior to PE chemotherapy in SCLC. The use of ifosfamide in multimodality treatment regimens needs to be studied further.
总共92例小细胞肺癌（SCLC）患者被随机分为两组，分别接受顺铂（80mg/m²，第1天）/依托泊苷（100mg/m²，第1、3、5天）（PE）或顺铂（80mg/m²，第1天）/依托泊苷（100mg/m²，第1、3、5天）/异环磷酰胺（2g/m²，第1、2、3天）（PEI）联合化疗。化疗2个疗程后，局限期（LD）患者接受40 - 50Gy的胸部放疗。在89例可进行全面评估的患者中，PE方案治疗的总缓解率为78%，PEI方案治疗的为74%（无统计学差异）。所有患者的完全缓解（CR）率分别为14%和21%，LD患者分别为22%和30%。然而，所有患者中，PE方案治疗的中位生存时间为55周，PEI方案治疗的为56周（无统计学差异）。所有患者的2年生存率分别为15%和17%（无统计学差异）。CR或部分缓解的病例中，PE和PEI方案治疗的缓解持续时间无差异。然而，PEI治疗后严重白细胞减少（<2000/mm³）的发生率（73%）高于PE治疗（44%）（p<0.05）。这些结果表明，在SCLC中PEI并不优于PE化疗。异环磷酰胺在多模式治疗方案中的应用需要进一步研究。
