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[非小细胞肺癌化疗的当前结果]

[Current results of chemotherapy in non-small cell lung cancer].

作者信息

Fukuoka M, Negoro S, Takada M, Matsui K, Takifuji N, Masuda N, Kawahara M, Furuse K

机构信息

Department of Internal Medicine, Osaka Prefectural Habikino Hospital, Japan.

出版信息

Nihon Kyobu Shikkan Gakkai Zasshi. 1990 Feb;28(2):203-9.

PMID:2162439
Abstract

From 1983 to 1988, two prospective randomized studies were conducted in the treatment of patients with inoperable non-small cell lung cancer (NSCLC). The first was a comparison of cisplatin (CDDP) alone vs CDDP plus vindesine (VDS) (CV-1), and the second was the comparison of CDDP plus VDS (CV-2) vs CDDP plus VDS plus mitomycin (MMC) (CVM) vs CDDP plus etoposide alternating with VDS plus MMC (CE/VM). A total of 345 patients entered into these two studies were evaluated. The response rates were 9.3% for CDDP alone, 26.8% for CV-1, 33.3% for CV-2, 42.6% for CVM, and 19.1% for CE/VE. There were significant differences in response rates between CDDP alone and CV-1 (p less than 0.01), and CVM and CE/VM (p less than 0.01). No differences were observed in the durations of response and survival among the five treatment arms. Females responded to chemotherapy better than males, and squamous cell carcinoma responded better than adenocarcinoma. Sex, performance status and stage were significant as prognostic factors in advanced NSCLC patients. Responders to chemotherapy live longer than nonresponders. In conclusion, CVM is considered to be currently best available regimen. No survival benefit has been proved for any treatments for advanced NSCLC. Chemotherapy for NSCLC is still investigational.

摘要

1983年至1988年,针对无法手术的非小细胞肺癌(NSCLC)患者开展了两项前瞻性随机研究。第一项研究比较了单纯顺铂(CDDP)与顺铂加长春地辛(VDS)(CV-1)的疗效,第二项研究比较了顺铂加VDS(CV-2)与顺铂加VDS加丝裂霉素(MMC)(CVM)以及顺铂加依托泊苷与VDS加MMC交替使用(CE/VM)的疗效。对纳入这两项研究的345例患者进行了评估。单纯使用顺铂的缓解率为9.3%,CV-1为26.8%,CV-2为33.3%,CVM为42.6%,CE/VE为19.1%。单纯顺铂与CV-1之间(p<0.01)以及CVM与CE/VM之间(p<0.01)的缓解率存在显著差异。在五个治疗组中,缓解持续时间和生存期未观察到差异。女性对化疗的反应优于男性,鳞状细胞癌的反应优于腺癌。性别、体能状态和分期是晚期NSCLC患者重要的预后因素。化疗反应者的生存期长于无反应者。总之,CVM被认为是目前最佳的可用方案。对于晚期NSCLC的任何治疗方法,均未证实有生存获益。NSCLC化疗仍处于研究阶段。

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[Current results of chemotherapy in non-small cell lung cancer].
Nihon Kyobu Shikkan Gakkai Zasshi. 1990 Feb;28(2):203-9.

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