Song Seo-Young, Kim Won Seog, Kim Kihyun, Jung Chul Won, Im Young Hyuck, Kim Ho Joong, Kang Won Ki, Lee Hong Ghi, Kwon O Jung, Rhee Chong H, Park Chan Hyung, Park Keunchil
Department of Internal Medicine, Kangwon National University Hospital, Kangwon-Do, Seoul, Korea.
Jpn J Clin Oncol. 2003 Oct;33(10):509-13. doi: 10.1093/jjco/hyg100.
Platinum-based chemotherapy improves survival and quality of life as compared with the best supportive care alone in advanced non-small cell lung cancer. In addition, several recent studies using new drugs such as docetaxel have demonstrated that second-line chemotherapy may be of value.
We studied the efficacy of combination treatment with vinorelbine, ifosfamide, and cisplatin (NIP) as salvage chemotherapy in patients with advanced non-small cell lung cancer (NSCLC). From March 1998 to December 1999, 44 previously treated patients (etoposide/cisplatin (EP): 36, EP--> taxane/cisplatin: 8) were treated with a chemotherapy regimen consisting of vinorelbine (25 mg/m(2) i.v. on days 1, 15 and 12.5 mg/m(2) i.v. on day 8), ifosfamide (3 g/m(2) i.v. on day 1 with mesna) and cisplatin (60 mg/m(2) i.v. on day 1). The cycles were repeated every 4 weeks.
All patients were evaluable for response. The median follow-up duration was 19.1 months (range, 4.4-28.3 months). The objective response rate was 27.3% (95% CI, 14.1%-40.5%) with one complete response and 11 partial responses. The median response duration was 4.1 months (range, 1.5-13 months). The median time to progression was 2.9 months (range, 0.7-15.3 months). The main toxicity was hematologic in the 138 evaluable courses, granulocytopenia (>or=grade III) and anemia (>or=grade III) were observed in 3.6% and 0.7% of the patients, respectively. Non-hematologic toxicities were minor and easily controlled. Four episodes of febrile neutropenia were reported. There were no treatment-related deaths.
In this study, the combination of vinorelbine, ifosfamide and cisplatin showed a significant efficacy with acceptable toxicities as salvage chemotherapy in previously treated advanced NSCLC patients.
与单纯最佳支持治疗相比，铂类化疗可提高晚期非小细胞肺癌患者的生存率和生活质量。此外，最近几项使用多西他赛等新药的研究表明，二线化疗可能具有价值。
我们研究了长春瑞滨、异环磷酰胺和顺铂联合（NIP）作为挽救性化疗方案治疗晚期非小细胞肺癌（NSCLC）患者的疗效。1998年3月至1999年12月，44例先前接受过治疗的患者（依托泊苷/顺铂（EP）：36例，EP→紫杉烷/顺铂：8例）接受了由长春瑞滨（第1天和第15天静脉注射25mg/m²，第8天静脉注射12.5mg/m²）、异环磷酰胺（第1天静脉注射3g/m²并加用美司钠）和顺铂（第1天静脉注射60mg/m²）组成的化疗方案。每4周重复一个周期。
所有患者均可评估疗效。中位随访时间为19.1个月（范围4.4 - 28.3个月）。客观缓解率为27.3%（95%CI，14.1% - 40.5%），1例完全缓解，11例部分缓解。中位缓解持续时间为4.1个月（范围1.5 - 13个月）。中位疾病进展时间为2.9个月（范围0.7 - 15.3个月）。在138个可评估疗程中，主要毒性为血液学毒性，粒细胞减少（≥Ⅲ级）和贫血（≥Ⅲ级）分别在3.6%和0.7%的患者中观察到。非血液学毒性较轻且易于控制。报告了4例发热性中性粒细胞减少症。无治疗相关死亡。
在本研究中，长春瑞滨、异环磷酰胺和顺铂联合方案作为挽救性化疗，在先前接受过治疗的晚期NSCLC患者中显示出显著疗效且毒性可接受。
