Harper P G, Souhami R L, Spiro S G, Geddes D M, Guimaraes M, Fearon F, Smyth J F
Cancer Treat Rep. 1982 Mar;66(3):463-70.
Ninety-eight patients with small cell carcinoma of the bronchus (SCCB) were treated with a combination of cyclophosphamide, methotrexate with calcium leucovorin rescue, and lomustine (CCNU). VP-16-213 was given on relapse. Response rate and survival were analyzed according to extent of tumor, presence of the syndrome of inappropriate antidiuretic hormone production (SIADH), and, in 38 patients, size of intrathoracic tumor as measured by computerized tomographic (CT) scanning. The median survival of the entire group was 34.6 weeks. In patients with limited disease the median survival was 46 weeks compared to 29 weeks for those with extensive disease. This difference in survival between patients with limited and extensive disease was most marked in those showing a partial response (median survival, 45.9 and 28 weeks, respectively). Patients with ectopic antidiuretic hormone production had a poor prognosis even if they had achieved a complete response. Only one partial response to VP-16-213 occurred. There was a strong correlation between initial intrathoracic tumor size as assessed by total cross-sectional area on CT scan and response and survival. When the total area exceeded 30 cm2 there were no complete responders, but there were complete responses in eight of 21 patients when the area was less than 30 cm2. The relationship between intrathoracic tumor size and response rate was present when analyzed according to disease extent, age, sex, and performance status. A clear relationship between total tumor area and survival was also found. When SCCB is treated with chemotherapy alone, the prognosis is better for those patients who present with limited disease, without SIADH, and with small intrathoracic tumor. In this group it is possible that further intensification of therapy may result in prolonged survival.
98例支气管小细胞癌（SCCB）患者接受了环磷酰胺、甲氨蝶呤加亚叶酸钙解救以及洛莫司汀（CCNU）联合治疗。复发时给予依托泊苷（VP - 16 - 213）。根据肿瘤范围、抗利尿激素分泌异常综合征（SIADH）的存在情况，以及对38例患者通过计算机断层扫描（CT）测量的胸内肿瘤大小，分析缓解率和生存率。整个组的中位生存期为34.6周。局限性疾病患者的中位生存期为46周，而广泛性疾病患者为29周。局限性和广泛性疾病患者在生存期上的差异在部分缓解者中最为明显（中位生存期分别为45.9周和28周）。即使异位抗利尿激素分泌患者已达到完全缓解，其预后仍较差。仅出现1例对VP - 16 - 213的部分缓解。通过CT扫描的总横截面积评估的初始胸内肿瘤大小与缓解和生存之间存在很强的相关性。当总面积超过30 cm²时，无完全缓解者，但当面积小于30 cm²时，21例患者中有8例出现完全缓解。根据疾病范围、年龄、性别和体能状态分析时，胸内肿瘤大小与缓解率之间的关系依然存在。还发现肿瘤总面积与生存之间存在明确关系。当单独用化疗治疗SCCB时，对于那些表现为局限性疾病、无SIADH且胸内肿瘤较小的患者，预后较好。在这组患者中，进一步强化治疗可能会延长生存期。
