McMahon L J, Herman T S, Manning M R, Dean J C
Cancer Treat Rep. 1979 Mar;63(3):359-62.
Twenty-seven patients with small cell carcinoma of the lung were treated sequentially with induction chemotherapy (adriamycin and cyclophosphamide), radiation therapy (chest and whole-brain), and then maintenance chemotherapy for 2 years. Twenty responding patients were followed to relapse and patterns of recurrence were observed. This combined treatment resulted in a complete remission rate of 80% and a median survival of 565 days in limited-disease patients. Relapse overwhelmingly occurred in the chest, but patients receiving higher-dose radiation (4000-4500 rads in split-course) had a significant prolongation of time to recurrence compared to patients receiving 3000 rads in a single course of radiation (540 versus 270 days). Despite a long mean survival, only one limited-disease patient relapsed outside of the brain or chest, suggesting that chemotherapy had a good protective effect against micrometastatic disease. Three patients relapsed in the brain at 330, 450, and 520 days, suggesting that in future studies the prophylactic whole-brain radiation (3000 rads) should be intensified.
27例小细胞肺癌患者先后接受诱导化疗（阿霉素和环磷酰胺）、放射治疗（胸部和全脑），然后进行为期2年的维持化疗。对20例有反应的患者进行随访直至复发，并观察复发模式。这种联合治疗使局限性疾病患者的完全缓解率达到80%，中位生存期为565天。复发绝大多数发生在胸部，但与接受单次放疗3000拉德的患者相比，接受更高剂量放疗（分程4000 - 4500拉德）的患者复发时间显著延长（分别为540天和270天）。尽管平均生存期较长，但只有1例局限性疾病患者在脑或胸部以外复发，这表明化疗对微转移疾病有良好的保护作用。3例患者分别在330天、450天和520天出现脑复发，提示在未来研究中应加强预防性全脑放疗（3000拉德）。
