Chou T, Yokoyama A, Yoshizawa H, Hoshino M, Ebe T, Kurita Y, Arakawa M
Dept. of Internal Medicine, Niigata Cancer Center Hospital.
Gan To Kagaku Ryoho. 1995 Oct;22(12):1741-8.
Feasibility and the efficacy of mega-dose chemotherapy with peripheral blood stem cell transplantation (PBSCT) for small cell lung cancer (SCLC) were evaluated. Autologous peripheral blood stem cell (APBSC) was collected after induction chemotherapy (Extensive disease: CDDP+etoposide+ADM, Limited disease: CDDP+etoposide) followed by the administration of granulocyte colony stimulating factor (G-CSF). Five cases of ED and 2 cases of LD have been entered in the protocol so far. PBSC was harvested after the second course of induction chemotherapy, and a sufficient number of PBSC (CFU-GM > or = 1 x 10(5)/kg) could be harvested and cryopreserved in all 7 cases. After completion of 4 courses of induction chemotherapy, three patients who achieved CR or good PR were treated by the combination of CBDCA (1,600 mg/m2) plus etoposide (1,600 mg/m2) followed by APBSCT and G-CSF. Hematologic recovery after APBSCT was rapid (absolute granulocyte count > 500/microliters: 9-11 day, Plt > 3 x 10(4)/microliters:10-14 day) and no infectious episode nor bleeding tendency occurred throughout the treatment period. Although grade 3 gastrointestinal toxicity was seen in one patient, the mega-dose chemotherapy with APBSCT in SCLC was considered safe and feasible. Further clinical trials are needed to establish the role of mega-dose chemotherapy for the treatment of SCLC.
评估了大剂量化疗联合外周血干细胞移植（PBSCT）治疗小细胞肺癌（SCLC）的可行性和疗效。诱导化疗（广泛期：顺铂+依托泊苷+阿霉素，局限期：顺铂+依托泊苷）后采集自体外周血干细胞（APBSC），随后给予粒细胞集落刺激因子（G-CSF）。迄今为止，已有5例广泛期和2例局限期患者进入该方案。在诱导化疗的第二个疗程后采集PBSC，所有7例患者均能采集到足够数量的PBSC（CFU-GM≥1×10⁵/kg）并进行冷冻保存。完成4个疗程的诱导化疗后，3例达到完全缓解（CR）或良好部分缓解（PR）的患者接受了卡铂（1600mg/m²）加依托泊苷（1600mg/m²）联合治疗，随后进行APBSCT和G-CSF治疗。APBSCT后的血液学恢复迅速（绝对粒细胞计数>500/微升：9-11天，血小板计数>3×10⁴/微升：10-14天），整个治疗期间未发生感染事件或出血倾向。虽然1例患者出现3级胃肠道毒性，但SCLC的大剂量化疗联合APBSCT被认为是安全可行的。需要进一步的临床试验来确定大剂量化疗在SCLC治疗中的作用。
