Lange A, Kołodziej J, Tomeczko J, Toporski J, Sedzimirska M, Jaźwiec B, Bocheńska J, Mróz E, Bielecka E, Was A
Bone Marrow Transplantation Unit K. Dłuski Hospital, Wrocław, Poland.
Arch Immunol Ther Exp (Warsz). 1991;39(4):431-9.
16 patients with an advanced stage SCLC were treated with the use of aggressive chemotherapy with bone marrow transplantation. With the gaining of experience the doses have been increased from standard-dose induction and 7 g/m2 of CTX in intensification to more aggressive induction (160 mg/kg of bw of CTX and 1.6 g/m2 VP-16 in two courses in 28 days interval) and intensification (CTX 7 g/m2 and VP-16 from 1.5 to 2.0 g/m2. Most recently, we used the following intensification which, in addition to the high dose CTX (6 g/m2), consisted of VP-16 0.9 g/m2 and BCNU 0.5 g/m2. The procedure proved to be safe. Hematological recovery emerged in all patients at a very similar time after autografting, irrespective to the late intensification regime. All cases, except one, received, after the hematological recovery, prophylactic cranial and at the primary tumor site irradiation as well as 2 to 4 courses of standard dose maintenance chemotherapy. The response rate was higher in the group receiving more aggressive induction and intensification. Long-term survival was seen only in patient which received more aggressive induction and intensification. Median survival of all cases was 13 months including 3 cases which are disease-free 24, 21 and 14 months after the beginning of the treatment.
16例晚期小细胞肺癌患者接受了积极化疗及骨髓移植治疗。随着经验的积累，剂量从标准剂量诱导及强化治疗时的7 g/m²环磷酰胺增加到更积极的诱导治疗（28天间隔内分两个疗程给予160 mg/kg体重的环磷酰胺及1.6 g/m²的依托泊苷）和强化治疗（环磷酰胺7 g/m²，依托泊苷从1.5 g/m²增加到2.0 g/m²）。最近，我们采用了以下强化治疗方案，除了高剂量环磷酰胺（6 g/m²）外，还包括0.9 g/m²的依托泊苷和0.5 g/m²的卡莫司汀。该治疗方法被证明是安全的。所有患者在自体移植后血液学恢复时间非常相似，与后期强化治疗方案无关。除1例患者外，所有病例在血液学恢复后均接受了预防性颅脑照射和原发肿瘤部位照射以及2至4个疗程的标准剂量维持化疗。接受更积极诱导和强化治疗的组缓解率更高。仅在接受更积极诱导和强化治疗的患者中观察到长期生存。所有病例的中位生存期为13个月，其中包括3例在治疗开始后24、21和14个月无病生存的患者。
