von Pawel Joachim
Asklepios Fachklinik, Gauting bei Munchen, Munich, Germany.
Lung Cancer. 2003 Aug;41 Suppl 4:S3-8. doi: 10.1016/s0169-5002(03)90519-8.
Small-cell lung cancer (SCLC) is highly chemosensitive but up to 70% of patients with limited disease and more than 90% of patients with extensive disease will relapse after first-line treatment. There are several standard chemotherapy regimens used for second-line treatment yet the prognosis for patients requiring this treatment remains poor. The topoisomerase-I inhibitor, topotecan, has achieved response rates of up to 22% in previously treated patients with SCLC and survival almost double that achieved with other single agents. Compared with cyclophosphamide/doxorubicin/vincristine (CAV), single-agent topotecan achieved a higher response rate, longer survival and statistically significant improvements in dyspnea, hoarseness, fatigue, anorexia and interference with daily activities. Brain metastases are common in SCLC. Topotecan crosses the blood-brain barrier and shows promise for the management of brain metastases.
小细胞肺癌（SCLC）对化疗高度敏感，但高达70%的局限性疾病患者和超过90%的广泛性疾病患者在一线治疗后会复发。有几种标准化疗方案用于二线治疗，但需要这种治疗的患者预后仍然很差。拓扑异构酶-I抑制剂拓扑替康在先前接受治疗的SCLC患者中已达到高达22%的缓解率，生存期几乎是其他单药治疗的两倍。与环磷酰胺/阿霉素/长春新碱（CAV）相比，单药拓扑替康达到了更高的缓解率、更长的生存期，并且在呼吸困难、声音嘶哑、疲劳、厌食和对日常活动的干扰方面有统计学上的显著改善。脑转移在SCLC中很常见。拓扑替康可穿过血脑屏障，对脑转移的治疗显示出前景。
