Saijo N
Internal Medicine and Thoracic Oncology Division, National Cancer Center Hospital, Tuskiji 5-1-1, Chuo-ku, Tokyo 104-0045, Japan.
Br J Cancer. 2003 Dec 15;89(12):2178-83. doi: 10.1038/sj.bjc.6601456.
Small-cell lung cancer (SCLC) accounts for approximately 15% of all cases of lung cancer and is a particularly aggressive form of lung cancer characterised by a poor prognosis, rapid tumour growth, and early metastasis. Roughly, two-thirds of patients with SCLC present with extensive disease (ED) and one-third with limited disease (LD). Combination chemotherapy is the most effective treatment modality for SCLC, and several new agents, including carboplatin, ifosfamide, taxans, and topotecan, have been demonstrated to be active; however, there are no data on the survival benefit of these drugs. A CPT-11+ cisplatin regimen has shown improvement in overall survival over the global gold standard regimen, etoposide + cisplatin (Japanese Clinical Oncology Group: JCOG 9511), and three confirmatory randomised controlled trials are in progress to determine the reproducibility of the JCOG 9511 study. JCOG is evaluating the role of CPT-11 and a new triplet regimen containing CPT-11 in limited-stage SCLC. Strategies and the current protocols of the JCOG are presented and discussed. In the future, it will be essential to evaluate molecular target-based drugs for LD and ED SCLC with new standard combination chemotherapy regimens that include CPT-11.
小细胞肺癌（SCLC）约占所有肺癌病例的15%，是一种侵袭性特别强的肺癌形式，其特点是预后差、肿瘤生长迅速且早期转移。大致上，三分之二的小细胞肺癌患者表现为广泛期疾病（ED），三分之一为局限期疾病（LD）。联合化疗是小细胞肺癌最有效的治疗方式，包括卡铂、异环磷酰胺、紫杉烷和拓扑替康在内的几种新药已被证明具有活性；然而，尚无关于这些药物生存获益的数据。与全球金标准方案依托泊苷+顺铂相比，CPT-11+顺铂方案已显示出总生存期有所改善（日本临床肿瘤学会：JCOG 9511），目前正在进行三项验证性随机对照试验以确定JCOG 9511研究的可重复性。日本临床肿瘤学会正在评估CPT-11以及含CPT-11的新三联方案在局限期小细胞肺癌中的作用。本文介绍并讨论了日本临床肿瘤学会的策略和当前方案。未来，使用包括CPT-11在内的新标准化联合化疗方案评估针对局限期和广泛期小细胞肺癌的分子靶向药物将至关重要。
