Ueoka H, Ohnoshi T, Hiraki S, Kamei H, Tabata M, Shibayama T, Miyatake K, Gemba K, Hiyama J, Kimura I
Second Department of Medicine, Okayama University Medical School.
Nihon Kyobu Shikkan Gakkai Zasshi. 1993 Dec;31 Suppl:218-24.
In order to assess the effectiveness of sequential TI for the treatment of LD SCLC, we analyzed 69 patients who had received CAV-PVP chemotherapy consisting of cyclophosphamide, adriamycin, vincristine, cisplatin and etoposide, plus sequential TI between 1986 and 1992. TI was delivered at a total dose of 50 Gy, 5 fractions/week for 5 weeks, once patients achieved a maximal response to chemotherapy. Responding patients also received PCI at a total dose of 30 Gy, 5 fractions/week for 3 weeks. Thirty patients achieved CR by chemotherapy and an additional 10 achieved CR after TI, resulting in a CR rate of 58.0%. Of 40 patients achieving CR, 24 have relapsed so far; the primary (in 15) and the brain (in 4) were the major sites of relapse despite TI and PCI. The median survival time was 18.4 months, with a 2-year survival rate of 39% and 3-year survival rate of 20%. Almost all the patients encountered grade 3 or grade 4 leukopenia while receiving chemotherapy, but the toxicity of TI was generally mild. This treatment is useful for patients with LD SCLC.
为了评估序贯胸部放疗（TI）治疗局限期小细胞肺癌（LD SCLC）的有效性，我们分析了1986年至1992年间接受由环磷酰胺、阿霉素、长春新碱、顺铂和依托泊苷组成的CAV - PVP化疗加序贯TI的69例患者。一旦患者对化疗达到最大反应，TI以总剂量50 Gy、每周5次、共5周的方式进行。有反应的患者还接受了总剂量30 Gy、每周5次、共3周的预防性颅脑照射（PCI）。30例患者通过化疗达到完全缓解（CR），另外10例在TI后达到CR，CR率为58.0%。在40例达到CR的患者中，到目前为止有24例复发；尽管进行了TI和PCI，主要部位（15例）和脑部（4例）仍是复发的主要部位。中位生存时间为18.4个月，2年生存率为39%，3年生存率为20%。几乎所有患者在接受化疗时都出现了3级或4级白细胞减少，但TI的毒性一般较轻。这种治疗方法对LD SCLC患者有用。
