Goss G D, Vincent M, Germond C, Corringham S, Rowen J, Dhaliwal H, Corringham R
Northeastern Ontario Regional Cancer Centre, University of Ottawa, Canada.
Am J Clin Oncol. 1993 Aug;16(4):295-300. doi: 10.1097/00000421-199308000-00004.
Seventy patients with previously untreated histologically proven small cell lung cancer (SCLC) were treated with a combination of teniposide 60 mg/m2 intravenously (i.v.) on days 1 through 5 and carboplatin 400 mg/m2 i.v. on day 1 every 28 days for six courses. Patients with limited stage disease, (LD) who achieved a response, subsequently received 2,000 cGy prophylactic cranial and 3,000 cGy involved field thoracic radiotherapy. Of the 70 patients, 62 were evaluable for response: 47 patients (76%) achieved an objective response; 14 of 29 patients (48%) with LD had a complete response (CR), with a partial response (PR) plus CR rate of 76%. Seven of 33 patients (21%) with extensive disease (ED) achieved a CR, with a combined PR and CR rate of 76%. Median time to progression (TTP) for all responders was 292 days (42 weeks). Median duration of survival for all LD patients was 415 days (59 weeks). Survival for LD patients was 88% at 6 months, 61% at 12 months, and 29% at 18 months. Median survival duration for all patients in the study was 311 days (44 weeks), with a survival of 79% at 6 months, 44% at 1 year, and 16% at 18 months. Myelosuppression was the main toxicity, with World Health Organization (WHO) grade 3 or 4 infection occurring in 33% of patients. Two patients died of pneumonia, one complicated by renal failure, and another suffered cardiac arrest related to treatment. The high activity of this drug combination justifies its use as a first-line treatment of previously untreated SCLC.
70例组织学确诊的初治小细胞肺癌（SCLC）患者接受了如下联合治疗：第1至5天静脉注射替尼泊苷60mg/m²，第1天静脉注射卡铂400mg/m²，每28天为一个疗程，共六个疗程。局限期（LD）且获得缓解的患者随后接受2000cGy的预防性全脑放疗及3000cGy的受累野胸部放疗。70例患者中，62例可评估疗效：47例（76%）获得客观缓解；29例LD患者中有14例（48%）完全缓解（CR），部分缓解（PR）加CR率为76%。33例广泛期（ED）患者中有7例（21%）获得CR，PR加CR率为76%。所有缓解者的中位疾病进展时间（TTP）为292天（42周）。所有LD患者的中位生存期为415天（59周）。LD患者6个月生存率为88%，12个月生存率为61%，18个月生存率为29%。本研究中所有患者的中位生存期为311天（44周），6个月生存率为79%，1年生存率为44%，18个月生存率为16%。骨髓抑制是主要毒性反应，33%的患者出现世界卫生组织（WHO）3级或4级感染。2例患者死于肺炎，1例并发肾衰竭，另1例死于与治疗相关的心脏骤停。这种联合用药的高活性证明其可作为初治SCLC的一线治疗方案。
