Negoro S, Fukuoka M
Dept. of Pulmonary Medicine, Osaka City General Hospital, Japan.
Gan To Kagaku Ryoho. 1995 Mar;22(4):451-60.
Recent progress in chemotherapy for advanced nonsmall cell lung cancer (NSCLC) and small cell lung cancer (SCLC) maybe summarized as follows. 1) In seven randomized trials of combination chemotherapy compared with best supportive care in stage IV NSCLC, meta-analysis of indicated that combination chemotherapy modestly improves survival of patients with advanced NSCLC. 2) Cisplatin-based combination chemotherapy followed by chest irradiation improves outcomes of patients with stage III unresectable NSCLC as compared with radiation therapy alone. 3) Meta-analysis has shown that survival is prolonged when radiotherapy is used in combination with chemotherapy in the treatment of limited-stage SCLC. 4) Randomized trials evaluating alternating chemotherapy could not demonstrate the survival benefit in the treatment of extensive-stage (ES) SCLC. 5) The approach to increasing dose intensity has been attempted in the treatment of ES-SCLC. The most common approach is weekly chemotherapy. Results of pilot studies have suggest that this approach prolong survival of patients with ES-SCLC. 6) Recently, several new drugs active against NSCLC and SCLC, including CPT-11, taxol, axotere, vinorelbine and gemcitabine, have been developed. In conclusion, despite these advances of treatment, the cure rate remains quite low in lung cancer. Further investigations are needed to improve the treatment results for patients with this disease.
晚期非小细胞肺癌（NSCLC）和小细胞肺癌（SCLC）化疗的近期进展可总结如下。1）在7项IV期NSCLC联合化疗与最佳支持治疗对比的随机试验中，荟萃分析表明联合化疗适度改善了晚期NSCLC患者的生存率。2）与单纯放疗相比，以顺铂为基础的联合化疗后行胸部放疗可改善III期不可切除NSCLC患者的预后。3）荟萃分析显示，在局限期SCLC的治疗中，放疗联合化疗可延长生存期。4）评估交替化疗的随机试验未能证明其在广泛期（ES）SCLC治疗中的生存获益。5）已尝试在ES-SCLC的治疗中增加剂量强度。最常见的方法是每周化疗。初步研究结果表明，这种方法可延长ES-SCLC患者的生存期。6）最近，已研发出几种对NSCLC和SCLC有效的新药，包括伊立替康、紫杉醇、多西他赛、长春瑞滨和吉西他滨。总之，尽管治疗有这些进展，但肺癌的治愈率仍然很低。需要进一步研究以改善该疾病患者的治疗效果。
