Vokes E E, Vijayakumar S, Hoffman P C, Ferguson M K, Bitran J D, Krishnasamy S, Jacobs R, Golomb H M
Department of Medicine, University of Chicago, Illinois.
Cancer. 1990 Aug 1;66(3):437-42. doi: 10.1002/1097-0142(19900801)66:3<437::aid-cncr2820660306>3.0.co;2-c.
Twenty-three patients with regionally advanced non-small cell lung cancer (NSCLC) (Stage III) were treated with continuous infusion 5-fluorouracil (5-FU) augmented by high-dose oral leucovorin and hydroxyurea and concomitant radiotherapy. This chemoradiotherapy regimen was administered during 5 days of every other week for six cycles (total radiation dose, 6000 cGy). Three patients (13%) had stable disease, 13 patients (57%) had a partial response (PR), and 1 patient (4%) had a complete response (CR). The overall response rate was 61% (95% confidence interval, 41% to 81%). At a median follow-up time of 19 months, the median survival time for all 23 patients was 12 months. The median time to disease progression was 6 months. Twelve patients have had disease progression outside of the chest, and only 3 patients have had intrathoracic disease progression as the site of first failure. The toxicities of this regimen consisted of mild to moderate myelosuppression and moderate degree dermatitis and mucositis. It was concluded that concomitant chemoradiotherapy with this regimen results in high local activity at acceptable toxicity. However, the systemic activity of this regimen was low, resulting in a high distant recurrence rate and a median survival time that was not different from that achieved with standard therapy. Therefore, its use, as defined in this study, cannot be recommended.
23例局部晚期非小细胞肺癌（NSCLC）（Ⅲ期）患者接受了持续输注5-氟尿嘧啶（5-FU）治疗，同时加用高剂量口服亚叶酸钙和羟基脲，并同步进行放疗。这种放化疗方案每隔一周的5天内给药，共进行6个周期（总放疗剂量6000 cGy）。3例患者（13%）疾病稳定，13例患者（57%）部分缓解（PR），1例患者（4%）完全缓解（CR）。总缓解率为61%（95%置信区间，41%至81%）。中位随访时间为19个月时，所有23例患者的中位生存时间为12个月。疾病进展的中位时间为6个月。12例患者出现胸部以外的疾病进展，只有3例患者以胸内疾病进展作为首次失败部位。该方案的毒性包括轻度至中度骨髓抑制以及中度皮炎和黏膜炎。得出的结论是，这种方案的同步放化疗在可接受的毒性下具有较高的局部活性。然而，该方案的全身活性较低，导致远处复发率较高，且中位生存时间与标准治疗无差异。因此，本研究中所定义的该方案的使用不能被推荐。
