Thatcher N, Wagstaff J, Wilkinson P, Palmer M, Crowther D
Cancer. 1982 Sep 15;50(6):1051-6. doi: 10.1002/1097-0142(19820915)50:6<1051::aid-cncr2820500605>3.0.co;2-x.
Fifty-seven patients with metastatic lung carcinoma were treated with either high-dose cyclophosphamide (Cy) alone or with a combination of high dose Cy and prednisolone (Pred) 100 mg/m2 orally daily for two days. The Cy was given IV on three occasions, at 1.5 g/m2, 2.5 g/m2 and 3.5 g/m2 with three-week intervals between courses. The overall response rate was 57% (18% CR), a median survival of 24 weeks (range, 6--130) for Cy alone, and 24% (3% CR), a median of 14 weeks (range, 1--94) for Cy + Pred. Patients with small cell carcinoma given Cy alone had a 69% response rate (19% CR), a median survival of seven months, and with non-small cell pathologic conditions 42% (16% CR), a median survival of 16 weeks. Performance scores and survival were better for responding patients. Addition of Pred did not improve the therapeutic efficacy of high dose Cy or ameliorate toxicity. No marked or unexpected toxicity was observed with the high-dose Cy regimen. The blood counts had returned to normal by three weeks in the great majority of patients. A short course of high-dose Cy was not associated with unacceptable side effects and the therapeutic results obtained were superior to those described for Cy at conventional dosage. High-dose Cy is of value to patients with metastatic lung cancer, and the incorporation of the regimen into chemotherapeutic combinations could be advantageous.
57例转移性肺癌患者接受了以下治疗：要么单独使用大剂量环磷酰胺（Cy），要么使用大剂量Cy与泼尼松龙（Pred）联合治疗，Pred剂量为100mg/m²，口服，每日1次，共2天。Cy分3次静脉给药，剂量分别为1.5g/m²、2.5g/m²和3.5g/m²，疗程间隔为3周。单独使用Cy的总缓解率为57%（完全缓解率为18%），中位生存期为24周（范围6 - 130周）；Cy + Pred组的总缓解率为24%（完全缓解率为3%），中位生存期为14周（范围1 - 94周）。单独接受Cy治疗的小细胞癌患者缓解率为69%（完全缓解率为19%），中位生存期为7个月；非小细胞病理类型患者的缓解率为42%（完全缓解率为16%），中位生存期为16周。缓解患者的体能状态评分和生存期更好。添加Pred并未提高大剂量Cy的治疗效果，也未改善毒性。大剂量Cy方案未观察到明显或意外的毒性。绝大多数患者在3周时血细胞计数恢复正常。短疗程大剂量Cy未出现不可接受的副作用，且所获得的治疗结果优于常规剂量Cy的报道。大剂量Cy对转移性肺癌患者有价值，将该方案纳入化疗联合方案可能有益。
