Zschaber R, Gatzemeier U, Koschel G, Kaukel E, Heilmann H P, Hossfeld D K
Abteilung Onkologie-Hämatologie der Medizinischen Klinik, Universitätskrankenhaus Eppendorf, Hamburg.
Onkologie. 1988;11 Suppl 2:9-12. doi: 10.1159/000216573.
In a prospective randomized study 150 patients with small cell lung carcinoma (80 cases with extended, 70 cases with limited disease) received either cisplatin + etoposide (DDP/VP) or cyclophosphamide + etoposide (cyclo/VP) as induction chemotherapy. Patients were crossed over when less than complete remission was achieved. Treatment failures received a salvage regimen with adriamycin + vindesine (ADM/VDS). Remission rates (complete + partial remissions) achieved with DDP/VP were 87.4% (40.6% + 46.8%) in limited disease and 72.2% (10.1% + 62.1%) in extended disease; response rates seen following cyclo/VP were 78.8% (31.5% + 47.3%) in limited and 51.0% (6.9% + 44.1%) in extended disease. Median survival time for patients in complete remission was 12.0 months following DDP/VP and 14 months following cyclo/VP; for patients in partial remission 10.0 and 9.0 months, respectively. The analysis of the treatment results shows an equal effectivity of both induction regimes which, however, seem to be largely cross resistant. DDP/VP probably causes more stable longtime remissions. The salvage regimen ADM/VDS was ineffective. The results achieved with this rather complex therapeutic strategy are not superior to those seen with simpler regimes.
在一项前瞻性随机研究中，150例小细胞肺癌患者（80例广泛期，70例局限期）接受顺铂+依托泊苷（DDP/VP）或环磷酰胺+依托泊苷（环磷酰胺/VP）作为诱导化疗。若未达到完全缓解，则患者交叉接受治疗。治疗失败的患者接受阿霉素+长春地辛（ADM/VDS）挽救方案。DDP/VP方案在局限期的缓解率（完全缓解+部分缓解）为87.4%（40.6%+46.8%），在广泛期为72.2%（10.1%+62.1%）；环磷酰胺/VP方案在局限期的缓解率为78.8%（31.5%+47.3%），在广泛期为51.0%（6.9%+44.1%）。完全缓解患者的中位生存时间，DDP/VP方案后为12.0个月，环磷酰胺/VP方案后为14个月；部分缓解患者分别为10.0个月和9.0个月。治疗结果分析显示，两种诱导方案的有效性相当，但似乎存在很大程度的交叉耐药。DDP/VP方案可能导致更稳定的长期缓解。挽救方案ADM/VDS无效。这种相当复杂的治疗策略所取得的结果并不优于更简单方案的结果。
