Carney D N, Keane M, Grogan L
Department of Medical Oncology, Mater Hospital, Dublin, Ireland.
Semin Oncol. 1992 Dec;19(6 Suppl 14):40-4.
Small cell lung cancer (SCLC) accounts for 25% of all cases of lung cancer diagnosed in the United States. The sensitivity of SCLC to chemotherapy offers good prospects for prolonged remission and long-term survival. Over the last decade, however, the overall response rate and median survival in SCLC patients have remained essentially unchanged. Single-agent intravenous (IV) etoposide has proven to be among the most active drugs for the treatment of SCLC. Oral or oral plus intravenous etoposide has been used in many combination chemotherapies. Studies demonstrating the schedule dependency of etoposide suggest that optimum results would be achieved if the total were administered over a minimum of 5 days. Given in such a schedule, oral etoposide has been shown to be effective in unfit or elderly (> 70 years of age) patients with SCLC, who represent 25% to 30% of the total SCLC population. Prolonged etoposide administration has achieved efficacy comparable with that attained in 5-day schedules, but with notable toxicity. Moreover, the value of dose intensity in single-agent and combination regimens employing etoposide has recently been questioned. New therapeutic strategies are clearly needed to increase the response rate, to prolong survival, and to improve quality of life in SCLC patients.
小细胞肺癌（SCLC）占美国确诊肺癌病例的25%。SCLC对化疗的敏感性为延长缓解期和长期生存提供了良好前景。然而，在过去十年中，SCLC患者的总体缓解率和中位生存期基本保持不变。单药静脉注射依托泊苷已被证明是治疗SCLC最有效的药物之一。口服或口服加静脉注射依托泊苷已用于多种联合化疗。证明依托泊苷给药方案依赖性的研究表明，如果总量在至少5天内给药，将取得最佳效果。按照这样的给药方案，口服依托泊苷已被证明对不适合或老年（>70岁）SCLC患者有效，这类患者占SCLC总人群的25%至30%。依托泊苷长期给药已达到与5天给药方案相当的疗效，但毒性显著。此外，在采用依托泊苷的单药和联合治疗方案中，剂量强度的价值最近受到质疑。明确需要新的治疗策略来提高SCLC患者的缓解率、延长生存期并改善生活质量.
