Evans W K, Shepherd F A, Feld R, Osoba D, DeBoer G
Semin Oncol. 1986 Sep;13(3 Suppl 3):17-23.
VP-16 and cisplatin were used as first-line therapy in 31 patients with small-cell lung cancer (SCLC) in whom chemotherapy regimens that contained doxorubicin (Adriamycin [Adria Laboratories, Columbus, Ohio]) were contraindicated because of severe cardiac or hepatic disease. Eight patients who had cerebral metastases at presentation were also included in the study. There were 11 patients with limited disease (LD) and 20 with extensive disease (ED). Of the 28 evaluable patients, 12 (43%) had a complete response (CR) and 12 (43%) had a partial response (PR). Four patients (14%) failed to respond. The median duration of response (MDR) for LD patients was 39 weeks and for ED patients was 26 weeks. Patients with LD who responded (CR and PR) had a median survival time (MST) of 70 weeks (range, 28 to 232+ weeks), whereas ED patients who responded had an MST of 43 weeks (range, 17 to 68 weeks). Gastrointestinal toxicity was mild, but leukopenia and thrombocytopenia were common. Mild degrees of reversible nephrotoxicity occurred in 15 patients, but required discontinuation of cisplatin in only two. The results of this study are compared with several other recently published reports of VP-16 and cisplatin used as first-line therapy in SCLC.
对于31例因严重心脏或肝脏疾病而禁忌使用含阿霉素（阿霉素[阿德里亚实验室，俄亥俄州哥伦布市]）化疗方案的小细胞肺癌（SCLC）患者，采用VP-16和顺铂作为一线治疗。研究还纳入了8例初诊时伴有脑转移的患者。其中11例为局限性疾病（LD）患者，20例为广泛性疾病（ED）患者。在28例可评估患者中，12例（43%）完全缓解（CR），12例（43%）部分缓解（PR）。4例患者（14%）无反应。LD患者的中位缓解持续时间（MDR）为39周，ED患者为26周。有反应的LD患者（CR和PR）的中位生存时间（MST）为70周（范围28至232 +周），而有反应的ED患者的MST为43周（范围17至68周）。胃肠道毒性较轻，但白细胞减少和血小板减少很常见。15例患者出现轻度可逆性肾毒性，但仅2例需要停用顺铂。本研究结果与其他几篇最近发表的关于VP-16和顺铂作为SCLC一线治疗的报告进行了比较。
