Loehrer P J, Einhorn L H, Greco F A
Department of Medicine, Indiana University School of Medicine, Indianapolis 46223.
Semin Oncol. 1988 Jun;15(3 Suppl 3):2-8.
Bronchogenic carcinoma is the leading cause of cancer related death in the United States. Approximately 20% to 25% of patients will present with small cell lung cancer (SCLC). The median survival time of patients treated with supportive care alone is about 2 to 4 months. Despite this grim prognosis, chemotherapy, with or without radiotherapy, has impacted upon the survival of patients with SCLC. Combination chemotherapy with agents such as cyclophosphamide, vincristine, and doxorubicin has routinely produced response rates of 60% to 80%. Subsequently, the median survival of treated patients has been lengthened to 10 to 14 months, with apparent cures in approximately 10% of patients with limited-stage disease. To improve these results, investigators have tried various treatment strategies, including evaluation of preclinical models of synergy, clinical trials with newer agents, and theoretic and practical considerations of dosing and scheduling. Recently, two groups of compounds, the epipodophyllotoxins and the platinum compounds have demonstrated single-agent activity in SCLC. This paper highlights the developmental role of two of these agents, cisplatin and etoposide, in this disease.
支气管源性癌是美国癌症相关死亡的主要原因。约20%至25%的患者会出现小细胞肺癌（SCLC）。仅接受支持性治疗的患者的中位生存时间约为2至4个月。尽管预后严峻，但化疗，无论是否联合放疗，都对SCLC患者的生存产生了影响。使用环磷酰胺、长春新碱和阿霉素等药物的联合化疗通常产生60%至80%的缓解率。随后，接受治疗患者的中位生存时间延长至10至14个月，约10%的局限期疾病患者出现明显治愈。为了改善这些结果，研究人员尝试了各种治疗策略，包括评估协同作用的临床前模型、使用新型药物的临床试验以及给药和疗程的理论与实际考量。最近，两组化合物，即鬼臼毒素类和铂类化合物，已在SCLC中显示出单药活性。本文重点介绍了其中两种药物顺铂和依托泊苷在该疾病中的发展作用。
