Farha P, Spitzer G, Valdivieso M, Dicke K A, Zander A, Dhingra H M, Minnhaar G, Vellekoop L, Verma D S, Umsawasdi T
Cancer. 1983 Oct 15;52(8):1351-5. doi: 10.1002/1097-0142(19831015)52:8<1351::aid-cncr2820520802>3.0.co;2-3.
Fourteen patients with untreated small cell bronchogenic carcinoma were treated initially with 2 chemotherapy courses of cyclophosphamide (1.5 g/m2 days 1-3), 4-dimethyl epipodophylloxtin (200 mg/m2 days 1-3), vincristine (1.5 mg/m2 days 1 and 3), and with Adriamycin (80 mg/m2 day 1) in 8 patients and without Adriamycin in 6 patients. To modify hematopoietic toxicity from these high doses of chemotherapy, autologous marrow collected and frozen before storage was thawed and infused after each of these high-dose therapies. After this therapy patients received prophylactic brain irradiation (3000 rad), 4 courses of usual doses of these same drugs and then 5000 rad chest irradiation if there was still evidence of disease (PR) or randomized to radiation if in complete remission (CR). Response rate was high, with 54% CR and 46% PR, a total of 100%. However, a median response duration of 41 weeks and median survival of 56 weeks, are similar to other chemotherapy programs. Toxicity was mild except for cardiac arrhythmias when Adriamycin was included. The reasons for no therapeutic increment are discussed.
14例未经治疗的小细胞支气管癌患者首先接受2个疗程的化疗，环磷酰胺（1.5g/m²，第1 - 3天）、4 - 去甲表鬼臼毒素（200mg/m²，第1 - 3天）、长春新碱（1.5mg/m²，第1天和第3天），8例患者加用阿霉素（80mg/m²，第1天），6例患者不加用阿霉素。为减轻这些高剂量化疗所致的造血毒性，在储存前采集并冷冻的自体骨髓在每次高剂量治疗后解冻并输注。该治疗后，患者接受预防性脑照射（3000拉德），4个疗程常规剂量的相同药物治疗，若仍有疾病证据（部分缓解）则随后接受5000拉德胸部照射，若完全缓解则随机接受放疗。缓解率较高，完全缓解率为54%，部分缓解率为46%，总计100%。然而，中位缓解持续时间为41周，中位生存期为56周，与其他化疗方案相似。除了使用阿霉素时出现心律失常外，毒性较轻。文中讨论了无治疗增效的原因。
