O'Donnell M R, Ruckdeschel J C, Baxter D, McKneally M F, Caradonna R, Horton J
Cancer Treat Rep. 1985 Jun;69(6):571-5.
The role of intensive induction chemotherapy in small cell cancer of the lung remains unclear. Twenty-eight newly diagnosed patients with small cell lung cancer were randomized to receive either high-dose or standard-dose cyclophosphamide, vincristine, and semustine in a trial where the dose of induction chemotherapy was the sole treatment variable. Complete responses (CR) were achieved in 57% of patients receiving high-dose therapy as compared to 21% of patients receiving standard-dose therapy (P less than 0.05). There was a higher rate of severe toxicity in the high-dose group (P less than 0.01). The overall median survival was not improved (36 weeks for the high-dose group vs 43 weeks for the standard-dose group); however, the median survival in patients achieving CR was prolonged (92 weeks for the high-dose group vs 50 weeks for the standard-dose group). These effects were most pronounced in patients with extensive disease; a CR after induction was achieved in five of nine patients treated with high doses but not in any of those treated with standard doses (P less than 0.05). A small group of patients appear to benefit by achieving a long-term remission with intensive induction chemotherapy, but this effect may be offset by increased morbidity.
强化诱导化疗在小细胞肺癌中的作用仍不明确。28例新诊断的小细胞肺癌患者被随机分组，在一项以诱导化疗剂量作为唯一治疗变量的试验中，分别接受高剂量或标准剂量的环磷酰胺、长春新碱和司莫司汀治疗。接受高剂量治疗的患者中有57%达到完全缓解（CR），而接受标准剂量治疗的患者中这一比例为21%（P<0.05）。高剂量组的严重毒性发生率更高（P<0.01）。总体中位生存期没有改善（高剂量组为36周，标准剂量组为43周）；然而，达到CR的患者的中位生存期延长了（高剂量组为92周，标准剂量组为50周）。这些效应在广泛期疾病患者中最为明显；9例接受高剂量治疗的患者中有5例在诱导治疗后达到CR，而接受标准剂量治疗的患者中无一例达到CR（P<0.05）。一小部分患者似乎通过强化诱导化疗实现长期缓解而获益，但这种效应可能会被发病率增加所抵消。
