Cullen M, Morgan D, Gregory W, Robinson M, Cox D, McGivern D, Ward M, Richards M, Stableforth D, Macfarlane A
Cancer Chemother Pharmacol. 1986;17(2):157-60. doi: 10.1007/BF00306746.
Since March 1980, 309 patients with anaplastic small cell carcinoma of the bronchus (ASCB) have received remission induction therapy prior to randomisation to maintenance (M) or no maintenance (NM) chemotherapy. Induction therapy consisted of six courses of vincristine, doxorubicin and cyclophosphamide (VAC) given IV every 3 weeks. Those with limited disease also received mediastinal irradiation. Consenting patients with no unequivocal residual disease were randomised to have no further treatment until relapse or a further eight courses of VAC, at a lower dosage, every 4 weeks. Patients failing to achieve randomisation status received palliative treatment only. The median survival for all patients with limited disease (LD) is 363 days and that for patients with extensive disease (ED) is 272 days (P less than 0.00001). Sixty-one patients with ED were randomised. Those having maintenance chemotherapy lived significantly longer (median 372 days) than those who did not continue therapy (median 259 days) (P = 0.006). An imbalance in the proportion of 'complete remitters' randomised to maintenance therapy does not account for this difference. There is no significant difference between the M and NM groups in the 32 randomised LD patients. Continuing treatment during remission with agents used to induce the remission can prolong survival in patients with extensive stage ASCB.
自1980年3月以来，309例支气管间变性小细胞癌（ASCB）患者在随机接受维持（M）或不接受维持（NM）化疗之前接受了缓解诱导治疗。诱导治疗包括每3周静脉注射长春新碱、阿霉素和环磷酰胺（VAC）六个疗程。病变局限的患者还接受了纵隔照射。同意参加研究且无明确残留疾病的患者被随机分为两组，一组在复发前不再接受进一步治疗，另一组每4周接受低剂量的VAC再治疗八个疗程。未能达到随机分组状态的患者仅接受姑息治疗。所有病变局限（LD）患者的中位生存期为363天，病变广泛（ED）患者的中位生存期为272天（P<0.00001）。61例ED患者被随机分组。接受维持化疗的患者生存期明显长于未继续治疗的患者（中位生存期分别为372天和259天）（P = 0.006）。随机接受维持治疗的“完全缓解者”比例失衡并不能解释这一差异。在32例随机分组的LD患者中，M组和NM组之间没有显著差异。使用诱导缓解的药物在缓解期继续治疗可延长广泛期ASCB患者的生存期。
