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[支气管癌的抗肿瘤化疗]

[Antineoplastic chemotherapy for bronchial carcinoma].

作者信息

Tanneberger S

出版信息

Arch Geschwulstforsch. 1985;55(1):63-71.

PMID:2985017
Abstract

With the non small-cell bronchial carcinoma, the results of tumor chemotherapy are, on the whole, still unsatisfactory. It remains to be seen whether the more recent preparations, such as Cisplatin, VP16, Vindesine or combinations there of which are at present extensively investigated, will change this situation. The combinations: Cyclophosphamide/Doxorubicin/Methotrexate/Procarbazine, Cyclophosphamide/Doxorubicin/Cisplatin or Vindesine/Cisplatin are considered most prospective, were remission rates are reported to range from 30-40% with a mean period of remission from 5-7 months. Such values are approximatively reached also by monochemotherapy, e.g. Cyclophosphamide, Adriamycin or Vinblastine. Thus, radiotherapy combined, if necessary, with tumor chemotherapy continues to be the therapy of choice for the non small-cell bronchial carcinoma. Entirely different is the situation with the small-cell bronchial carcinoma. Here, with polychemotherapy being clearly superior to monochemotherapy, 80% of objective remissions are achieved with limited extension of the tumor, and 65%, with advanced tumor progression. The remissions may last here up to 18 months. Combinations of proven value are: Doxorubicin/Cyclophosphamide/Vincristine and VP16/Doxorubicin/Cyclophosphamide, with Cyclophosphamide being contained virtually in all proposed combinations as an essential component. Repeatedly proposed has also been the alternating application of non cross-resistant therapeutic schedules, e.g. VP16/Procarbazine and Cyclophosphamide/Lomustine/Vincristine/Procarbazine. For the inoperable small-cell bronchial carcinoma, chemotherapy is the therapy of choice. In how far additional radiotherapy will further improve the therapeutic results is now being intensively investigated. A high likelihood in this regard exists for a "prophylactic" irradiation of the CNS.

摘要

对于非小细胞支气管癌,总体而言,肿瘤化疗的结果仍不尽人意。目前正在广泛研究的一些较新的制剂,如顺铂、依托泊苷、长春地辛或它们的组合,是否会改变这种情况还有待观察。以下组合:环磷酰胺/阿霉素/甲氨蝶呤/丙卡巴肼、环磷酰胺/阿霉素/顺铂或长春地辛/顺铂被认为最具前景,据报道缓解率在30%至40%之间,平均缓解期为5至7个月。单药化疗,如环磷酰胺、阿霉素或长春碱,也大致能达到这样的值。因此,必要时放疗联合肿瘤化疗仍是非小细胞支气管癌的首选治疗方法。

小细胞支气管癌的情况则完全不同。在这里,联合化疗明显优于单药化疗,肿瘤局限期的客观缓解率为80%,肿瘤进展期为65%。这里的缓解期可持续长达18个月。已证实有价值的组合有:阿霉素/环磷酰胺/长春新碱和依托泊苷/阿霉素/环磷酰胺,几乎所有提议的组合中都将环磷酰胺作为基本成分包含在内。也多次有人提议交替应用非交叉耐药的治疗方案,如依托泊苷/丙卡巴肼和环磷酰胺/洛莫司汀/长春新碱/丙卡巴肼。对于无法手术的小细胞支气管癌,化疗是首选治疗方法。额外的放疗在多大程度上会进一步改善治疗效果目前正在深入研究。在这方面,对中枢神经系统进行“预防性”放疗很有可能。

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