Souhami R L, Finn G, Gregory W M, Birkhead B G, Buckman R, Edwards D, Goldstone A H, Harper P G, Spiro S G, Tobias J S
J Clin Oncol. 1985 Jul;3(7):958-63. doi: 10.1200/JCO.1985.3.7.958.
Eighteen patients with untreated small-cell cancer of the lung have been treated with cyclophosphamide 200 mg/kg on two occasions at an interval of four weeks. An additional eight patients received etoposide in addition to cyclophosphamide. Measurements of tumor volume were made by thoracic computed tomographic (CT) scan before and after each cycle. When compared with our previous study in which only one cycle of cyclophosphamide was given, the double procedure did not increase response rate, decrease the incidence of local relapse, or prolong the relapse-free interval. Survival after relapse was shorter with two cycles of chemotherapy mainly due to greater difficulty in administering further chemotherapy. The CT scans showed a decrease in tumor volume from 99.2 cc to 21 cc after the first cycle, but a smaller decrease to 14.1 cc after the second. These results show that the rapid emergence of drug resistance imposes limitations on the use of very high-dose cytotoxic chemotherapy.
18例未经治疗的小细胞肺癌患者接受了环磷酰胺治疗，剂量为200mg/kg，分两次给药，间隔四周。另外8例患者除环磷酰胺外还接受了依托泊苷治疗。在每个周期前后通过胸部计算机断层扫描（CT）测量肿瘤体积。与我们之前仅给予一个周期环磷酰胺的研究相比，双周期治疗并未提高缓解率、降低局部复发率或延长无复发生存期。复发后的生存期在接受两个周期化疗时更短，主要是因为后续化疗给药难度更大。CT扫描显示，第一个周期后肿瘤体积从99.2立方厘米降至21立方厘米，但第二个周期后仅降至14.1立方厘米。这些结果表明，耐药性的快速出现限制了高剂量细胞毒性化疗的应用。
