Arriagada R, le Chevalier T, Ruffie P, Baldeyrou P, De Cremoux H, Martin M, Chomy P, Cerrina M L, Pellae-Cosset B, Tarayre M
Institut Gustave-Roussy, Villejuif, France.
Int J Radiat Oncol Biol Phys. 1990 Nov;19(5):1135-8. doi: 10.1016/0360-3016(90)90217-8.
One-hundred seventy-three patients with limited small cell lung cancer were included in three consecutive protocols alternating radiotherapy and chemotherapy. The alternating schedule consisted of six courses of chemotherapy (doxorubicin, VP16213, cyclophosphamide, and methotrexate in the first protocol; methotrexate being replaced by cisplatinum in the other two protocols) and three series of thoracic radiotherapy delivering a total dose of 45, 55, and 65 Gy in each consecutive protocol. Radiotherapy was started after the second course of chemotherapy. A 1-week gap was respected between each course of chemotherapy and each series of radiotherapy. Seventy percent of patients were in complete remission at the end of the induction treatment. The actuarial 5-year local control was 60% and the 5-year overall survival was 18%. Sixty percent of patients developed distant metastases. The death rate unrelated to cancer was 10%. These results show that alternating radiotherapy and chemotherapy schedules are reproducible, and provide a consistent long-term local control and a long-term survival rate exceeding 15% in limited disease.
173例局限期小细胞肺癌患者被纳入三个连续的交替放疗与化疗方案。交替方案包括六个化疗疗程（第一个方案使用阿霉素、VP16 - 213、环磷酰胺和甲氨蝶呤；在另外两个方案中，甲氨蝶呤被顺铂替代）以及三个系列的胸部放疗，在每个连续方案中分别给予45、55和65 Gy的总剂量。放疗在第二个化疗疗程后开始。每个化疗疗程与每个放疗系列之间间隔1周。诱导治疗结束时，70%的患者完全缓解。精算5年局部控制率为60%，5年总生存率为18%。60%的患者发生远处转移。与癌症无关的死亡率为10%。这些结果表明，交替放疗与化疗方案具有可重复性，并且在局限期疾病中能提供持续的长期局部控制以及超过15%的长期生存率。
