Einhorn L H
Semin Oncol. 1986 Sep;13(3 Suppl 3):5-9.
Cisplatin plus VP-16 has become a widely used salvage regimen for CAV (cyclophosphamide, doxorubicin [Adriamycin], and vincristine) failures. However, the major value of this two-drug combination will probably be as an integral part of the initial therapeutic strategy. Cisplatin plus VP-16 has been used as induction therapy in four separate published studies involving 238 patients. The response rates ranged from 71% to 94% and complete remission (CR) rates varied from 30% to 53%. Cisplatin plus VP-16 has also been alternated with CAV in several phase II studies with encouraging results. A Southeastern Cancer Study Group (SECSG) protocol in extensive disease is currently testing this hypothesis in a random prospective study. A recently completed SECSG protocol in limited small-cell lung cancer tested the concept of late intensification with two courses of cisplatin plus VP-16 following six courses of CAV, v six courses of CAV alone. Presently, there is a statistically significant survival advantage for cisplatin plus VP-16.
顺铂加依托泊苷已成为治疗环磷酰胺、阿霉素和长春新碱（CAV）方案治疗失败后的广泛应用的挽救方案。然而，这种两药联合方案的主要价值可能在于作为初始治疗策略的一个组成部分。顺铂加依托泊苷已在四项涉及238例患者的独立发表研究中用作诱导治疗。缓解率为71%至94%，完全缓解（CR）率在30%至53%之间。在几项II期研究中，顺铂加依托泊苷也与CAV交替使用，结果令人鼓舞。东南癌症研究组（SECSG）一项针对广泛期疾病的方案目前正在一项随机前瞻性研究中检验这一假设。SECSG最近完成的一项针对局限性小细胞肺癌的方案，测试了在六个疗程的CAV之后，再进行两个疗程顺铂加依托泊苷的晚期强化概念，与之对照的是单纯六个疗程的CAV。目前，顺铂加依托泊苷在生存方面有统计学意义的优势。
