Gressner Olav, Popp Henning, Mey Ulrich, Friedrichs Nicolaus, Strehl John, Sauerbruch Tilman, Schmidt-Wolf Ingo G H, Gorschlüter Marcus
Department of Internal Medicine I, University Hospital of Bonn, Germany.
Onkologie. 2008 Sep;31(8-9):469-72. doi: 10.1159/000142396. Epub 2008 Aug 15.
Small cell lung cancer (SCLC) results in death within 1-2 months if left untreated. Although therapeutic standards only comprise first- and second-line chemotherapy due to poor prognosis, a subset of patients may warrant a trial of further chemotherapy, as demonstrated in the following case.
We present a 52-year-old man with confirmed anaplastic SCLC who survived 10 years while receiving 9 lines of chemotherapy including high-dose chemotherapy. Thoracic radiation, afterloading and radionuclide therapy supplemented the therapeutic management. Remarkably, he had two very long remission periods following topotecan.
This case indicates that frequently repeated chemotherapy beyond second-line treatment in a subset of patients with limited-disease SCLC may result in long-term survival, even without ever achieving a complete remission. Close surveillance of responsiveness and appropriate in-time cytostatic treatment is proposed in the management of patients with SCLC who remain in good performance.
小细胞肺癌（SCLC）若不治疗，会在1至2个月内导致死亡。尽管由于预后较差，治疗标准仅包括一线和二线化疗，但如下例所示，一部分患者可能值得尝试进一步化疗。
我们报告一名52岁确诊为间变性SCLC的男性患者，其在接受包括大剂量化疗在内的9线化疗期间存活了10年。胸部放疗、后装治疗和放射性核素治疗辅助了治疗管理。值得注意的是，他在使用拓扑替康后有两个很长的缓解期。
该病例表明，一部分局限期SCLC患者在二线治疗后频繁重复化疗可能会导致长期生存，即使从未实现完全缓解。对于身体状况良好的SCLC患者，建议密切监测反应性并及时进行适当的细胞毒性治疗。
