Behera D, Aggarwal A N, Sharma S C, Gupta D, Jindal S K
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Chest Dis Allied Sci. 2004 Jan-Mar;46(1):9-15.
Combination chemotherapy has been demonstrated as one of the best active regimens in patients with non-small cell lung cancer (NSCLC).
A total of 206 patients with advanced unresectable NSCLC stage III B or stage IV were enrolled to receive combination chemotherapy with mitomycin, ifosfamide and cisplatin. About a third of them (n=63) did not continue therapy after the first course either because of toxicity, lack of affordability, or death. The remaining 143 patients (121 males) received two or more cycles of chemotherapy.
Nearly half of all followed-up patients showed a partial or complete radiological response. Overall performance status (Karnofsky scale) worsened in 28 (19.6%) and improved in 44 (30.8%). While 50 patients (35%) gained weight, 65 (45.5%) lost weight during follow-up. Overall median survival was 20 weeks [95% confidence interval (CI), 16 to 24 weeks]. However, overall survival improved progressively with the number of chemotherapy cycles administered. Median survival in patients receiving at least three, four and five chemotherapy cycles was 23 (95% CI, 19-27); 27 (95% CI, 24-30) and 35 (95% CI, 28-42) weeks respectively. Survival at the end of three, six, nine and 12 months was 64.3%, 29.4%, 14.7% and 9.8%) respectively. Survival had no association with age of the patient, but was significantly correlated with baseline performance status (Pearson's correlation coefficient 0.29 p<0.01). The cost of each course of chemotherapy was a little over 100 US dollars. The side effects were minimal and acceptable, and the regimen was tolerated well by all the patients.
Ifosfamide regimen containing mitomycin and cisplatin is a chemotherapeutic combination for treating patients with advanced NSCLC.
联合化疗已被证明是治疗非小细胞肺癌（NSCLC）患者的最佳有效方案之一。
共纳入206例晚期不可切除的ⅢB期或Ⅳ期NSCLC患者，接受丝裂霉素、异环磷酰胺和顺铂的联合化疗。其中约三分之一（n = 63）的患者在第一个疗程后因毒性、经济负担或死亡而未继续治疗。其余143例患者（121例男性）接受了两个或更多周期的化疗。
几乎一半的随访患者显示出部分或完全的影像学缓解。总体功能状态（卡氏评分）在28例（19.6%）患者中恶化，在44例（30.8%）患者中改善。在随访期间，50例（35%）患者体重增加，65例（45.5%）患者体重减轻。总体中位生存期为20周[95%置信区间（CI），16至24周]。然而，总体生存期随着化疗周期数的增加而逐渐改善。接受至少三个、四个和五个化疗周期的患者的中位生存期分别为23周（95%CI，19 - 27）；27周（95%CI，24 - 30）和35周（95%CI，28 - 42）。三个月、六个月、九个月和十二个月末的生存率分别为64.3%、29.4%、14.7%和9.8%。生存率与患者年龄无关，但与基线功能状态显著相关（Pearson相关系数0.29，p < 0.01）。每个化疗疗程的费用略高于100美元。副作用轻微且可接受，所有患者对该方案耐受性良好。
含丝裂霉素和顺铂的异环磷酰胺方案是治疗晚期NSCLC患者的一种化疗联合方案。
