Cha R J, Zeng D W, Chang Q S
General Hospital of PLA, Beijing.
Zhonghua Nei Ke Za Zhi. 1994 Jul;33(7):462-6.
54 consecutive cases of small cell lung cancer (SCLC) were treated with longterm short-interval combined treatment modalities of chemotherapy, radiotherapy (55-65 GY), immunotherapy, traditional Chinese medicine (leaf of Asiatic Ginseng, root of Astragalus membranaceus Bge, etc) and other adjuvants. Chemotherapy consisted of vincristine, cyclophosphamide, methotrexate and carmustine. A complete response of 59.2%, partial response of 38.9% and an overall response of 98.1% were achieved. According to Kaplan-Meier, the survival rates of SCLC with limited disease for 1, 3, 5 and 10 years were 78.1%, 42.6%, 32.1% and 21.4% respectively; while those with extensive disease for 1, 3, and 5 years 90.5%, 13.4% and 13.4%. According to classification of international TNM staging (1988), the survival rates of stage II SCLC for 1, 3, 5 and 10 years were 92.9%, 61.9%, 53.1% and 31.8% respectively; of stage IIIa for 1, 3 and 5 years 80.0%, 30.0% and 20.0%, and of stage IIIb 83.3%, 20.8% and 15.6%. Our combined modalities raised the survival rates considerably; the improved effect was mainly due to the long-term (especially more than 2 years or 10 courses), short-interval, effective and timely combined treatment with chemotherapy, radiotherapy and adjuvants such as traditional Chinese medicine and immunotherapy. By using the above therapeutic strategy, 10 out of 12 SCLC patients including 4 with extensive disease, who were relatives of our hospital staffs, have gained more than 3-17 years of survival. Therefore small cell lung cancer even with extensive disease was a hopeful curable disease.
对54例连续的小细胞肺癌（SCLC）患者采用化疗、放疗（55 - 65GY）、免疫治疗、中药（人参叶、黄芪根等）及其他辅助治疗的长期短间隔联合治疗模式。化疗药物包括长春新碱、环磷酰胺、甲氨蝶呤和卡莫司汀。完全缓解率为59.2%，部分缓解率为38.9%，总缓解率为98.1%。根据Kaplan - Meier法，局限期SCLC患者1年、3年、5年和10年生存率分别为78.1%、42.6%、32.1%和21.4%；广泛期患者1年、3年和5年生存率分别为90.5%、13.4%和13.4%。根据国际TNM分期（1988年），Ⅱ期SCLC患者1年、3年、5年和10年生存率分别为92.9%、61.9%、53.1%和31.8%；Ⅲa期患者1年、3年和5年生存率分别为80.0%、30.0%和20.0%，Ⅲb期为83.3%、20.8%和15.6%。我们的联合治疗模式显著提高了生存率；改善效果主要归因于长期（尤其是超过2年或10个疗程）、短间隔、有效且及时地联合化疗、放疗以及中药和免疫治疗等辅助治疗。采用上述治疗策略，12例SCLC患者中有10例，包括4例广泛期患者（均为我院职工亲属），已获得3至17年以上的生存。因此，即使是广泛期的小细胞肺癌也是有望治愈的疾病。
