Rushing D A, Friedenberg W R, Baldauf M C, Broste S, Gehlsen J A, Kriesel D H, Koontz D P, Rodvold K A
Department of Oncology, Marshfield Clinic, WI 54449.
Cancer. 1991 Aug 15;68(4):720-4. doi: 10.1002/1097-0142(19910815)68:4<720::aid-cncr2820680409>3.0.co;2-r.
Fourteen patients with small cell carcinoma of the lung in relapse or with disease refractory to chemotherapy were treated with carmustine (BCNU) at doses of 600 to 1000 mg/m2 intravenously followed by autologous bone marrow transplantation. All patients previously were treated with cyclophosphamide, doxorubicin, vincristine, and etoposide. Seven of the 14 patients responded to the high-dose BCNU (50% response with 95% confidence limits ranging from 23% to 77%). Three patients had a complete response, and four had a partial response. Regrowth of tumor occurred within 60 days of treatment in the responding patients. Death occurred in six patients before the recovery of the platelet count to 50,000 cells/microliters. Although the response rate was high, the toxicity was excessive. In the dosage range of 600 to 1000 mg/m2 in heavily pretreated patients, BCNU is not recommended, but additional investigation may be warranted in patients with central nervous system metastases who previously were treated with radiation therapy.
14例复发或化疗难治的小细胞肺癌患者接受了卡莫司汀（BCNU）治疗，静脉注射剂量为600至1000mg/m²，随后进行自体骨髓移植。所有患者此前均接受过环磷酰胺、多柔比星、长春新碱和依托泊苷治疗。14例患者中有7例对高剂量BCNU有反应（50%的反应率，95%置信区间为23%至77%）。3例患者完全缓解，4例部分缓解。缓解患者在治疗后60天内肿瘤复发。6例患者在血小板计数恢复至50,000细胞/微升之前死亡。尽管反应率较高，但毒性过大。在接受过大量预处理的患者中，不推荐使用600至1000mg/m²剂量范围的BCNU，但对于先前接受过放射治疗的中枢神经系统转移患者，可能有必要进行进一步研究。
