Frytak S, Shaw J N, Lee R E, Eagan R T, Shaw E G, Richardson R L, Creagan E T, Coles D T, Jett J R
Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota.
Cancer Invest. 1988;6(6):669-76. doi: 10.3109/07357908809078033.
A total of 211 patients with limited small cell lung cancer were assessed retrospectively for long-term toxicities, treatment-related deaths, and second primaries. All had received treatment with various combinations of doxorubicin, vincristine, cisplatin, lomustine, cyclophosphamide, and etoposide with or without split-course thoracic radiotherapy (4,000 cGy/10 fractions) and/or split-course prophylactic cranial irradiation (3,600 cGy/10 fractions). Sixty-eight (32%) of the patients survived longer than 1.5 years and formed the basis of this study. Debilitating pulmonary, cardiac, and neurologic toxicity was noted in 12%, 14%, and 15%, respectively, of long-term survivors. These complications were the result of aggressive combined modality therapy. Certain drugs appeared to cause additive toxicity when combined with radiation. Three patients developed new primary tumors of squamous cell origin. Attention must be directed to defining the safest way to employ aggressive combined modality treatment for these patients.
对211例局限期小细胞肺癌患者进行回顾性评估，以了解其长期毒性、治疗相关死亡情况及第二原发肿瘤。所有患者均接受了阿霉素、长春新碱、顺铂、洛莫司汀、环磷酰胺和依托泊苷的不同组合治疗，部分患者接受了分程胸部放疗（4000 cGy/10次分割）和/或分程预防性颅脑照射（3600 cGy/10次分割）。68例（32%）患者存活超过1.5年，构成了本研究的基础。长期存活者中，分别有12%、14%和15%出现了导致身体衰弱的肺部、心脏和神经毒性。这些并发症是积极联合治疗方式的结果。某些药物与放疗联合使用时似乎会产生叠加毒性。3例患者出现了鳞状细胞起源的新原发性肿瘤。必须关注确定对这些患者采用积极联合治疗方式的最安全方法。
