Hardman P D, Green J A, Errington R D, Myint S, Warenius H M
CRC Department of Radiation Oncology, Clatterbridge Hospital, Bebington, Wirral, England.
Med Oncol Tumor Pharmacother. 1989;6(3):227-32. doi: 10.1007/BF02985195.
Seventy-seven patients with small cell lung cancer were entered on a protocol comprising induction chemotherapy with cyclophosphamide 1 g m-2, adriamycin 40 mg m-2 and vincristine 1.4 mg m-2 (CAV) every 21 days for four to six cycles. The overall response rate was 72.8%. Twenty-six patients achieving complete remission received intensification with two further cycles of ifosfamide 5 g m-2, mesna 8 g m-2, methotrexate 30 mg m-2 and etoposide 100 mg m-2 per day for 3 days (IME). Six of the 15 patients in partial remission following CAV achieved a further remission on IME (response rate 40%). Median survival in the limited disease group was 11 months compared with 7 months in the extensive disease patients and four patients are alive at more than 2 yr follow up. There was no significant prolongation of the median survival (11 months) seen in those patients in complete remission who had negative second bronchoscopy examination. This sequential six drug regime produces high response rates in small cell lung cancer, and there is evidence of lack of cross-resistance between CAV and IME.
77例小细胞肺癌患者进入一项方案，该方案包括每21天进行一次诱导化疗，使用环磷酰胺1 g/m²、阿霉素40 mg/m²和长春新碱1.4 mg/m²（CAV方案），共进行4至6个周期。总体缓解率为72.8%。26例达到完全缓解的患者接受强化治疗，使用异环磷酰胺5 g/m²、美司钠8 g/m²、甲氨蝶呤30 mg/m²和依托泊苷100 mg/m²，每天一次，共3天（IME方案），进行两个周期。CAV方案后部分缓解的15例患者中有6例在IME方案治疗后进一步缓解（缓解率40%）。局限期疾病组的中位生存期为11个月，而广泛期疾病患者为7个月，4例患者在随访2年以上仍存活。第二次支气管镜检查阴性的完全缓解患者的中位生存期（11个月）无显著延长。这种序贯六药方案在小细胞肺癌中产生了高缓解率，并且有证据表明CAV方案和IME方案之间不存在交叉耐药。
