Pujol J L, Rossi J F, Le Chevalier T, Daurès J P, Rouanet P, Douillard J Y, Dubois J B, Arriagada R, Mary H, Godard P
Hôpital l'Aiguelongue, Montpellier, France.
Eur J Cancer. 1990;26(7):798-801. doi: 10.1016/0277-5379(90)90155-m.
33 patients with locally advanced non-small cell lung cancer entered a study of neoadjuvant chemotherapy to evaluate the response rate with ifosfamide/cisplatin/etoposide and the complete resection rate and safety of surgery following chemotherapy. Chemotherapy with cisplatin 25 mg/m2, ifosfamide 1.5 g/m2, and etoposide 100 mg/m2 was given on days 1-4 of a 21 day cycle and repeated for three cycles. For responders, surgery was done 15-20 days after haematological recovery. Chemotherapy induced 5 complete responses (15%) and 18 partial responses (55%). 77% of the 33 patients had grade 3-4 neutropenia and 60% grade 3-4 thrombocytopenia. 1 patient died with a central nervous system haemorrhage. Thoracotomy was done in 21 patients but resection was only possible in 20 (61%). A complete resection was achieved in 18 patients (55%). Histology was negative for the 5 complete responses. Surgery induced no morbidity. A high response rate may be obtained with ifosfamide, cisplatin and etoposide neoadjuvant chemotherapy allowing a high complete resection rate.
33例局部晚期非小细胞肺癌患者进入一项新辅助化疗研究，以评估异环磷酰胺/顺铂/依托泊苷的缓解率以及化疗后手术的完全切除率和安全性。在21天周期的第1 - 4天给予顺铂25mg/m²、异环磷酰胺1.5g/m²和依托泊苷100mg/m²进行化疗，重复三个周期。对于有反应者，在血液学恢复后15 - 20天进行手术。化疗诱导5例完全缓解（15%）和18例部分缓解（55%）。33例患者中有77%出现3 - 4级中性粒细胞减少，60%出现3 - 4级血小板减少。1例患者死于中枢神经系统出血。21例患者接受了开胸手术，但仅20例（61%）可行切除。18例患者（55%）实现了完全切除。5例完全缓解患者的组织学检查为阴性。手术未引发并发症。异环磷酰胺、顺铂和依托泊苷新辅助化疗可获得较高的缓解率，从而实现较高的完全切除率。
