Girling D J, Stott H, Stephens R J, Fox W
Br J Cancer. 1985 Dec;52(6):867-73. doi: 10.1038/bjc.1985.271.
The 15-year findings are presented of a double-blind, randomised study planned in 1964 in which cytotoxic chemotherapy with either busulphan or cyclophosphamide prescribed to be given daily for 2 years as an adjuvant to surgery was compared with placebo in the treatment of 726 patients with carcinoma of the bronchus. The two cytotoxic agents administered in this way did not influence survival. At 15y, 8% of the 243 patients allocated busulphan, 9% of the 234 cyclophosphamide, and 10% of the 249 placebo were alive, these being 10% of the patients who had had epidermoid cancers, 12% large-cell, 5% small-cell, 5% adenocarcinomas, and 8% other histological types. The study provides data on long-term results in a large group of patients who were, in effect, treated by surgery alone. Survival was significantly shorter in patients with histological involvement of the resected intrathoracic nodes (log-rank test P much less than 0.001). A finding of particular interest is that the histological type of the tumour did not influence survival in the 390 patients whose nodes were not involved, although, as expected, it did in the 336 whose nodes were involved, the 226 with epidermoid cancers surviving longer than the 57 with small cell carcinoma, the 31 with adenocarcinoma and all 110 with non-epidermoid carcinomas (P much less than 0.001 in each comparison).
本文呈现了一项1964年规划的双盲随机研究的15年随访结果。该研究中，726例支气管癌患者被随机分为三组，其中243例接受白消安、234例接受环磷酰胺进行细胞毒性化疗，这两种化疗药物均规定每日给药，持续2年，作为手术辅助治疗，另外249例接受安慰剂治疗。结果显示，以这种方式给予的两种细胞毒性药物对生存率没有影响。15年后，接受白消安治疗的243例患者中有8%存活，接受环磷酰胺治疗的234例患者中有9%存活，接受安慰剂治疗的249例患者中有10%存活。这些存活患者中，鳞状细胞癌患者占10%，大细胞癌患者占12%，小细胞癌患者占5%，腺癌患者占5%，其他组织学类型患者占8%。该研究提供了一大组实际上仅接受手术治疗的患者的长期结果数据。经胸内淋巴结切除组织学检查发现有转移的患者生存率显著较低（对数秩检验P远小于0.001）。一个特别有趣的发现是，在390例淋巴结未受累的患者中，肿瘤的组织学类型不影响生存率，不过，正如预期的那样，在336例淋巴结受累的患者中，组织学类型确实影响生存率，226例鳞状细胞癌患者的生存期长于57例小细胞癌患者、31例腺癌患者以及所有110例非鳞状细胞癌患者（每项比较P均远小于0.001）。
