Osterlind K, Sörenson S, Hansen H H, Dombernowsky P, Hirsch F R, Hansen M, Rørth M
Cancer Res. 1983 Dec;43(12 Pt 1):6085-9.
In a 2-year period, 146 patients with small cell carcinoma of the lung, staged as having extensive disease, were randomized to receive either continuous chemotherapy consisting of (a) 1-(2-chloroethyl-3-cyclohexyl-1-nitrosourea, cyclophosphamide, methotrexate, and vincristine followed by (b) 4'-demethylepipodophyllotoxin 9-[4,6-O-(R) ethylidene-beta-D-glucopyranoside] and doxorubicin at progression of disease or a regimen of (a) alternating with (b). Seventy-six patients received the continuous regimen; 70 patients received alternating treatment. Response rates were 68 and 72%, respectively. The median duration of response was 16 weeks in patients receiving continuous treatment compared to 28 weeks in patients receiving alternating treatment (p less than 0.05). No survival time difference was observed between the groups, median survival being 36 and 38 weeks, respectively. Four patients became long-term survivors (5.6 +, 5.5 +, 5.1, and 4.7 + years). All received alternating therapy. Six toxic deaths were observed among patients receiving continuous therapy compared to only one death among those in the alternating regimen. In conclusion, alternating combination chemotherapy leads to prolonged duration of remission. Duration of survival is not prolonged in uncured patients, but an increased possibility of long-term disease-free survival cannot be precluded.
在两年期间，146例被分期为广泛期疾病的小细胞肺癌患者被随机分配接受以下治疗：一是持续化疗，方案为（a）1-(2-氯乙基)-3-环己基-1-亚硝基脲、环磷酰胺、甲氨蝶呤和长春新碱，随后（b）在疾病进展时使用4'-去甲基表鬼臼毒素9-[4,6-O-(R)-亚乙基-β-D-吡喃葡萄糖苷]和阿霉素；另一种方案是（a）与（b）交替使用。76例患者接受持续化疗方案，70例患者接受交替治疗方案。缓解率分别为68%和72%。接受持续治疗的患者中位缓解持续时间为16周，而接受交替治疗的患者为28周（p<0.05）。两组之间未观察到生存时间差异，中位生存期分别为36周和38周。4例患者成为长期存活者（5.6+、5.5+、5.1和4.7+年）。所有患者均接受交替治疗。接受持续治疗的患者中有6例发生毒性死亡，而接受交替治疗方案的患者中仅1例死亡。总之，交替联合化疗可延长缓解期。未治愈患者的生存期并未延长，但不能排除长期无病生存可能性增加的情况。
