Ohta M, Hara N, Ichikawa Y, Kanda T, Shima K, Tamura K, Hokama M
Dept. of Chest Surgery, National Kyushu Cancer Center Hospital.
Gan To Kagaku Ryoho. 1988 Jun;15(6):1901-8.
We studied the efficacy of cisplatin-based polychemotherapy for non-small-cell lung cancer. One hundred nineteen patients with adenocarcinoma or large cell carcinoma were randomized to receive cyclophosphamide, adriamycin, cisplatin and mitomycin C (CAPM) or mitomycin C, cytosine arabinoside and tegafur (MCT), and 48 patients with squamous cell carcinoma were randomized to receive cisplatin, adriamycin and peplomycin (PAP) or mitomycin C, cyclophosphamide, tespamine, toyomycin and tegafur (MCTTT). Radiation was given to the chest in patients with stage I-III disease. The response rates were CAPM, 34.5%; MCT, 13.1% (p less than 0.01) and PAP, 63.3%; MCTTT, 42.3%. A significant difference in response rate between the CAPM and MCT regimens was observed only in stage IV patients and not in stage I-III patients. The median survival was 9.5 months in the CAPM arm vs. 6.5 months in the MCT arm (p less than 0.007), and 8.5 months in the PAP arm vs. 6.5 months in the MCTTT arm. Improved median survival for the CAPM regimen was noted only in stage IV patients and not in stage I-III patients when compared to patients given the MCT regimen, respectively. Nausea and vomiting were significantly increased in patients with cisplatin-based polychemotherapy. Myelosuppression was more severe with the CAPM regimen than with the other chemotherapy regimens. We concluded that cisplatin-based polychemotherapy, CAPM and PAP therapy were of more benefit to patients with disseminated non-small-cell lung cancer than MCT and MCTTT therapy.
我们研究了以顺铂为基础的多药化疗对非小细胞肺癌的疗效。119例腺癌或大细胞癌患者被随机分为接受环磷酰胺、阿霉素、顺铂和丝裂霉素C(CAPM)或丝裂霉素C、阿糖胞苷和替加氟(MCT)治疗,48例鳞状细胞癌患者被随机分为接受顺铂、阿霉素和培洛霉素(PAP)或丝裂霉素C、环磷酰胺、替司帕明、东洋霉素和替加氟(MCTTT)治疗。I - III期疾病患者接受胸部放疗。缓解率分别为:CAPM组34.5%;MCT组13.1%(p<0.01);PAP组63.3%;MCTTT组42.3%。仅在IV期患者中观察到CAPM和MCT方案之间缓解率存在显著差异,而在I - III期患者中未观察到。CAPM组的中位生存期为9.5个月,MCT组为6.5个月(p<0.007),PAP组为8.5个月,MCTTT组为6.5个月。与接受MCT方案的患者相比,CAPM方案改善的中位生存期仅在IV期患者中观察到,而在I - III期患者中未观察到。以顺铂为基础的多药化疗患者恶心和呕吐明显增加。CAPM方案的骨髓抑制比其他化疗方案更严重。我们得出结论,对于播散性非小细胞肺癌患者,以顺铂为基础的多药化疗、CAPM和PAP治疗比MCT和MCTTT治疗更有益。