Bishop J F, Kefford R, Raghavan D, Zalcberg J, Stuart-Harris R, Ball D, Olver I N, Friedlander M, Bull C, Yuen K
Peter MacCallum Cancer Institute, Melbourne, Australia.
Cancer Chemother Pharmacol. 1990;25(5):367-70. doi: 10.1007/BF00686239.
The efficacy and toxicity of 120 mg/m2 etoposide and 100 mg/m2 carboplatin given i.v. daily x 3 together with 750 mg/m2 cyclophosphamide and 1.4 mg/m2 vincristine given i.v. on day 1 (ECCO) in a regimen given every 28 days for 6 courses was assessed in 90 (40 limited stage, 50 extensive stage) previously untreated patients with small-cell lung cancer. Mediastinal irradiation using 50 Gy in 25 fractions was given to limited-stage patients without progression after 3 courses of chemotherapy. Cranial irradiation with 30 Gy in 10 fractions was given to all patients attaining a complete response (CR). Objective responses were seen in 83% [CR, 60%; partial response (PR), 23%] of patients with limited and 76% (CR, 22%; PR, 54%) of those with extensive disease. The median relapse-free survival for objective responders with limited disease was 13.4 months, with a median of 8.0 months for extensive-stage patients. The median relapse-free survival for patients achieving a CR was 13.4 months, with a median of 7.8 months for those undergoing a PR. The median survival was 13.3 months for patients with limited disease, with a median of 9.6 months for those with extensive disease. The median survival following a CR was 18.2 months, with a median survival of 9.9 months for those showing a PR. The combination was well tolerated, with either no nausea or nausea only (WHO grade 0 or 1) in 56% of patients and minimal mucositis, renal toxicity, neurotoxicity or ototoxicity. Neutropenia measuring less than 1.0 x 10(9) WBC/l (WHO grade 3 or 4) was seen in 74% of patients, with two deaths due to infection occurring during neutropenia. Thrombocytopenia of less than 50 x 10(9) platelets/l (WHO grade 3 or 4) occurred in 24% of patients. ECCO is a new, active, well-tolerated program for previously untreated patients with small-cell lung cancer.
对90例（40例局限期、50例广泛期）未经治疗的小细胞肺癌患者评估了每28天为一个疗程、共6个疗程的治疗方案，该方案为静脉注射120mg/m²依托泊苷和100mg/m²卡铂，每日1次，共3天，同时在第1天静脉注射750mg/m²环磷酰胺和1.4mg/m²长春新碱（ECCO方案）。局限期患者在接受3个疗程化疗后若病情无进展，则给予25次分割、总量50Gy的纵隔放疗。所有达到完全缓解（CR）的患者均接受10次分割、总量30Gy的颅脑放疗。局限期患者的客观缓解率为83%（CR，60%；部分缓解[PR]，23%），广泛期患者为76%（CR，22%；PR，54%）。局限期客观缓解者的无复发生存期中位数为13.4个月，广泛期患者为8.0个月。达到CR的患者无复发生存期中位数为13.4个月，PR患者为7.8个月。局限期患者的总生存期中位数为13.3个月，广泛期患者为9.6个月。CR后的总生存期中位数为18.2个月，PR患者为9.9个月。该联合方案耐受性良好，56%的患者无恶心或仅有轻微恶心（世界卫生组织0级或1级），且黏膜炎、肾毒性、神经毒性或耳毒性轻微。74%的患者出现中性粒细胞减少，白细胞计数低于1.0×10⁹/L（世界卫生组织3级或4级），2例患者在中性粒细胞减少期间因感染死亡。24%的患者出现血小板减少，血小板计数低于50×10⁹/L（世界卫生组织3级或4级）。ECCO方案是一种针对未经治疗的小细胞肺癌患者的新的、有效的、耐受性良好的治疗方案。
