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基于细胞类型的支气管源性癌联合化疗

[Combination chemotherapy for bronchogenic carcinoma based on cell type].

作者信息

Ohta M, Hara N, Ichikawa Y, Kanda T, Shima K, Hokama M

出版信息

Gan To Kagaku Ryoho. 1986 Jan;13(1):86-94.

PMID:2417564
Abstract

Based on the cell types in bronchogenic carcinoma, we treated 123 patients with different regimens of combination chemotherapy. The chemotherapy regimens consisted of CAP (cyclophosphamide + adriamycin + platinum) for 60 patients with adenocarcinoma and large cell carcinoma, PP (peplomycin + platinum) for 29 patients with squamous cell carcinoma and CAV (cyclophosphamide + adriamycin + vincristine) for 35 patients with small cell carcinoma. These regimens were repeated every 4 weeks for at least 2 cycles. The response rates for CAP, PP and CAV were 18.3% (11 PR), 20.7% (6 PR) and 60% (10 CR + 11 PR), respectively. Median survival time (MST) was 12.5 months for CAP, 8.5 months for PP and 9.5 months for CAV. Responders had a significantly (P less than 0.002) improved survival (MST, 15.5 months) compared to non-responders (MST, 7.5 months) in small cell carcinoma. However, there was no significant difference between responders and non-responders in CAP and PP. Survival of patients with PS 0-1 was significantly better than that with PS 2-3 in all treated patients. Nausea and vomiting were severe in patients treated with platinum-based polychemotherapy. There was no renal failure although a transient increase of serum creatinine was noted in CAP and PP. Myelosuppression was mild to moderate in all patients treated with CAP, PP and CAV.

摘要

根据支气管源性癌的细胞类型,我们采用不同的联合化疗方案治疗了123例患者。化疗方案包括:60例腺癌和大细胞癌患者采用CAP(环磷酰胺+阿霉素+铂)方案;29例鳞状细胞癌患者采用PP(培洛霉素+铂)方案;35例小细胞癌患者采用CAV(环磷酰胺+阿霉素+长春新碱)方案。这些方案每4周重复一次,至少进行2个周期。CAP、PP和CAV方案的有效率分别为18.3%(11例部分缓解)、20.7%(6例部分缓解)和60%(10例完全缓解+11例部分缓解)。CAP方案的中位生存时间(MST)为12.5个月,PP方案为8.5个月,CAV方案为9.5个月。在小细胞癌中,与未缓解者(MST,7.5个月)相比,缓解者的生存期显著改善(P<0.002,MST,15.5个月)。然而,CAP和PP方案的缓解者与未缓解者之间无显著差异。在所有接受治疗的患者中,PS 0-1的患者生存期明显优于PS 2-3的患者。接受铂类多药化疗的患者恶心和呕吐严重。尽管在CAP和PP方案中血清肌酐有短暂升高,但未出现肾衰竭。接受CAP、PP和CAV方案治疗的所有患者骨髓抑制均为轻至中度。

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