Miles D W, Earl H M, Souhami R L, Harper P G, Rudd R, Ash C M, James L, Trask C W, Tobias J S, Spiro S G
Medical Oncology Clinic, Guy's Hospital, London, England.
J Clin Oncol. 1991 Feb;9(2):280-5. doi: 10.1200/JCO.1991.9.2.280.
A weekly, intensive chemotherapy regimen has been used to treat 70 patients with small-cell lung cancer (SCLC). Forty-five patients had limited disease (LD) and 25 extensive disease (ED) with good prognostic features. The regimen consisted of cisplatin 50 mg/m2 intravenously (IV) day 1 and etoposide 75 mg/m2 IV days 1 and 2, alternating weekly with ifosfamide 2 g/m2 IV day 8 and doxorubicin 25 mg/m2 IV day 8, for a total of 12 weeks. Dose modifications were made according to defined hematologic criteria. Responding patients with limited disease subsequently received mediastinal radiotherapy. Overall response to chemotherapy was 91% with a complete response (CR) rate of 50%. Forty-five patients with limited disease (LD) achieved an overall response rate of 91% with a CR rate of 51%, and 25 patients with extensive disease (ED) achieved an overall response rate of 92% with a CR rate of 48%. Median survival for the whole group was 54 weeks (LD, 58 weeks; ED, 42 weeks). Hematologic toxicity was predictable, without the wide fluctuations in WBC count seen in conventional 3-weekly regimens. In all, one quarter of treatment courses were delayed, most frequently because of leukopenia. Dose reductions were required in 63% of cases. The average delivered dose intensity was calculated and shown to be 73% of projected. Nonhematologic toxicity was mild with nausea and vomiting being the most common. This weekly schedule of chemotherapy has proved to be active and well tolerated and is currently being compared with conventional 3-weekly chemotherapy in a randomized study.
一种每周强化化疗方案已被用于治疗70例小细胞肺癌（SCLC）患者。45例患者为局限性疾病（LD），25例为广泛性疾病（ED）且具有良好的预后特征。该方案包括第1天静脉注射（IV）顺铂50mg/m²以及第1天和第2天静脉注射依托泊苷75mg/m²，每周交替使用第8天静脉注射异环磷酰胺2g/m²和第8天静脉注射阿霉素25mg/m²，共12周。根据既定的血液学标准进行剂量调整。有反应的局限性疾病患者随后接受纵隔放疗。化疗的总体缓解率为91%，完全缓解（CR）率为50%。45例局限性疾病（LD）患者的总体缓解率为91%，CR率为51%，25例广泛性疾病（ED）患者的总体缓解率为92%，CR率为48%。整个组的中位生存期为54周（LD为58周；ED为42周）。血液学毒性是可预测的，不像传统的每3周方案那样白细胞计数有大幅波动。总共四分之一的疗程被推迟，最常见的原因是白细胞减少。63%的病例需要降低剂量。计算得出平均给药剂量强度为预计剂量的73%。非血液学毒性较轻，最常见的是恶心和呕吐。这种每周化疗方案已被证明有效且耐受性良好，目前正在一项随机研究中与传统的每3周化疗进行比较。
