Taylor C W, Crowley J, Williamson S K, Miller T P, Taylor S A, Giri T G, Stephens R L, Livingston R B
University of Arizona, Arizona Cancer Center, Tucson.
J Clin Oncol. 1990 Nov;8(11):1811-7. doi: 10.1200/JCO.1990.8.11.1811.
We designed an intensive, weekly treatment regimen for patients with small-cell lung cancer (SCLC) using six of the most active chemotherapeutic agents for this disease (doxorubicin [DOX], cyclophosphamide [CTX], vincristine [VCR], etoposide [VP-16], cisplatin [CDDP], and methotrexate [MTX]). The goal of this program was to gain rapid, repetitive exposure to multiple, active drugs. Treatment was administered weekly for a total of 16 weeks. Seventy-six SCLC patients (limited disease, 34; extensive disease, 42) were treated. The overall complete plus partial response rate was 82%. Complete response rates of 47% and 38% were observed in patients with limited (LD) and extensive disease (ED), respectively. The median survivals for patients with LD and ED were 16.6 and 11.4 months, respectively. Toxicities were tolerable and were primarily hematologic. Twenty-six patients had one or more transient life-threatening toxicities, but only one patient developed a fatal toxicity. Eighty-four percent of the patients received 80% or greater of the intended protocol dosages over the entire 16-week treatment period. We conclude that this intensive, short-duration treatment regimen is at least as good as other "standard" regimens, and we are encouraged aged by the complete response rate and median survival in patients with ED SCLC.
我们为小细胞肺癌（SCLC）患者设计了一种强化的每周治疗方案，使用针对该疾病的六种最有效的化疗药物（阿霉素[DOX]、环磷酰胺[CTX]、长春新碱[VCR]、依托泊苷[VP - 16]、顺铂[CDDP]和甲氨蝶呤[MTX]）。该方案的目标是使患者快速、反复接触多种有效药物。治疗每周进行一次，共持续16周。76例SCLC患者（局限期34例；广泛期42例）接受了治疗。总体完全缓解加部分缓解率为82%。局限期（LD）和广泛期（ED）患者的完全缓解率分别为47%和38%。LD和ED患者的中位生存期分别为16.6个月和11.4个月。毒性反应可耐受，主要为血液学毒性。26例患者出现一种或多种短暂的危及生命的毒性反应，但只有1例患者发生致命毒性反应。在整个16周的治疗期间，84%的患者接受了80%或更高剂量的预定方案剂量。我们得出结论，这种强化的短疗程治疗方案至少与其他“标准”方案一样有效，并且广泛期SCLC患者的完全缓解率和中位生存期让我们备受鼓舞。
