Yoshida S, Ogata T, Homma T, Kikuchi K, Masuda H, Matsuoka T, Sugiyama K, Noguchi Y, Yoneda S, Fukuda T
Gan To Kagaku Ryoho. 1986 Jul;13(7):2331-6.
Thirty-nine patients with small cell carcinoma of the lung were treated sequentially with induction chemotherapy, radiotherapy and then maintenance chemotherapy. Induction chemotherapy consisted of two regimens, cyclophosphamide, vincristine, methotrexate (COM) and adriamycin, ACNU, vindecine (ANV) given by randomization. Radiotherapy was given for patients with limited disease (LD) as a rule. After radiotherapy the drugs used for maintenance chemotherapy were alternated and reduced in dose. Eighteen patients were treated with a COM-ANV sequential combination and sixteen patients were treated with an ANV-COM combination. Thirteen patients had limited disease (LD) and eleven patients had extensive disease (ED). Of 12 patients with LD treated with COM-ANV therapy, 9 patients (75%) responded with 3 (25%) complete responses. Of 11 patients with LD treated with ANV-COM therapy, 9 patients (81.8%) responded to the therapy. According to disease extent, response rate was 82.6% for LD and 54.5% for ED. The median survival times were 9 months for patients with COM-ANV therapy and 12 months for those with ANV-COM therapy. Also, the median survival time was 15 months for LD patients and 5 months for ED patients. Major toxicities in ANV therapy were anorexia, nausea, and myelosuppression, and were more frequent than with COM therapy. These results showed no clear evidence of superiority in either the COM-AMV or ANV-COM regimen.
三十九例小细胞肺癌患者先后接受了诱导化疗、放疗，然后是维持化疗。诱导化疗由两种方案组成，随机给予环磷酰胺、长春新碱、甲氨蝶呤（COM）和阿霉素、阿糖胞苷、长春地辛（ANV）。通常对局限性疾病（LD）患者进行放疗。放疗后，用于维持化疗的药物交替使用并减少剂量。18例患者接受COM-ANV序贯联合治疗，16例患者接受ANV-COM联合治疗。13例患者为局限性疾病（LD），11例患者为广泛性疾病（ED）。在接受COM-ANV治疗的12例LD患者中，9例（75%）有反应，3例（25%）完全缓解。在接受ANV-COM治疗的11例LD患者中，9例（81.8%）对治疗有反应。根据疾病范围，LD患者的缓解率为82.6%，ED患者为54.5%。接受COM-ANV治疗的患者中位生存时间为9个月，接受ANV-COM治疗的患者为12个月。此外，LD患者的中位生存时间为15个月，ED患者为5个月。ANV治疗的主要毒性为厌食、恶心和骨髓抑制，比COM治疗更常见。这些结果表明，COM-AMV或ANV-COM方案均无明显优势。
