Tummarello D, Guidi F, Torresi U, Isidori P, Rossi A, Dazzi C, Cellerino R
Department of Clinical Oncology, University of Ancona, Italy.
Acta Oncol. 1990;29(4):417-20. doi: 10.3109/02841869009090023.
Seventy-four patients with small cell lung cancer (SCLC) entered a program consisting of induction with three courses of CAV (cyclophosphamide, doxorubicin and vincristine) in limited disease or two courses of CAV plus two courses of DDP-VP16 (cisplatin, etoposide) in extensive disease, followed by chest radiotherapy (45 Gy) and prophylactic brain irradiation (30 Gy) in responsive patients. Subsequently, patients with response or stable disease received maintenance therapy by alternating courses of CAV, DDP-VP16 and C'MP (CCNU, methotrexate, procarbazine) during 1 year or until relapse. Sixty-seven patients were evaluable. Among 24 patients with limited disease 7/23 (30%) showed complete response, 15/23 (65%) partial response and 1/23 (5%) stable disease. Among 50 patients with extensive disease 1/44 (2%) showed complete response, 21/44 (48%) partial response, 13/44 (30%) stable disease and 9/44 (20%) progressive disease. Actuarial median survival in all patients was 8 months, in responders 11 months, and in failures (stable plus progressive patients) 4 months. Median survival was 11 months in limited disease patients and 7 months in extensive disease patients. Six patients became long-term survivors (8%). Despite the maintenance therapy with three different alternating chemotherapy regimens, our results were not superior to those obtained by more conventional chemotherapy.
74例小细胞肺癌（SCLC）患者进入了一个治疗方案，该方案包括对局限性疾病患者采用3个疗程的CAV（环磷酰胺、阿霉素和长春新碱）进行诱导治疗，对广泛性疾病患者采用2个疗程的CAV加2个疗程的DDP-VP16（顺铂、依托泊苷）进行诱导治疗，随后对有反应的患者进行胸部放疗（45 Gy）和预防性脑照射（30 Gy）。随后，有反应或病情稳定的患者在1年期间或直至复发时，通过交替使用CAV、DDP-VP16和C'MP（洛莫司汀、甲氨蝶呤、丙卡巴肼）疗程进行维持治疗。67例患者可进行评估。在24例局限性疾病患者中，7/23（30%）显示完全缓解，15/23（65%）部分缓解，1/23（5%）病情稳定。在50例广泛性疾病患者中，1/44（2%）显示完全缓解，21/44（48%）部分缓解，13/44（30%）病情稳定，9/44（20%）病情进展。所有患者的精算中位生存期为8个月，有反应者为11个月，无反应者（病情稳定加进展患者）为4个月。局限性疾病患者的中位生存期为11个月，广泛性疾病患者为7个月。6例患者成为长期存活者（8%）。尽管采用了三种不同的交替化疗方案进行维持治疗，但我们的结果并不优于采用更传统化疗所获得的结果。
