Arriagada R, Le Chevalier T, Ruffié P, Chomy P, de Cremoux H
Institut Gustave-Roussy (IGR), Villejuif, France.
Lung Cancer. 1994 Mar;10 Suppl 1:S289-98. doi: 10.1016/0169-5002(94)91693-4.
Two-hundred two patients with limited small cell lung cancer were tested by four consecutive alternating radiotherapy and chemotherapy protocols. The alternating schedule consisted of six cycles of chemotherapy (doxorubicin, etoposide, and cyclophosphamide, plus methotrexate in the first protocol; cisplatin replaced methotrexate in the other three protocols) and three courses of thoracic radiotherapy at a total dose of 45, 55, 65 and 61 Gy in the four consecutive protocols, respectively. A 1-week rest followed each chemotherapy cycle and each course of radiotherapy. Seventy-six percent of patients were in complete remission at the end of the induction treatment. Overall results showed a 2-year cumulative incidence rate of failure of 75%. The first cause of failure was local recurrence only, 33%; distant only, 25%; distant and local simultaneously, 9%; and intercurrent death, 8%. Overall survival rate at 5 years was 16%. No significant differences were observed between the four treatment groups. Alternating radio-chemotherapy approaches are feasible and currently included in Phase III trials.
202例局限期小细胞肺癌患者接受了四个连续交替放疗和化疗方案的治疗。交替方案包括六个周期的化疗（第一个方案为阿霉素、依托泊苷和环磷酰胺，加甲氨蝶呤；其他三个方案中顺铂替代了甲氨蝶呤）以及三个疗程的胸部放疗，四个连续方案的总剂量分别为45、55、65和61 Gy。每个化疗周期和每个放疗疗程后休息1周。诱导治疗结束时76%的患者完全缓解。总体结果显示2年累积失败发生率为75%。失败的首要原因仅为局部复发，占33%；仅远处转移，占25%；远处和局部同时转移，占9%；并发死亡，占8%。5年总生存率为16%。四个治疗组之间未观察到显著差异。交替放化疗方法可行，目前已纳入III期试验。
