Grunberg S M, Crowley J, Livingston R, Gill I, Williamson S K, O'Rourke T, Braun T, Marshall M E, Weick J K, Balcerzak S P
University of Southern California School of Medicine, Los Angeles.
J Clin Oncol. 1993 Aug;11(8):1598-601. doi: 10.1200/JCO.1993.11.8.1598.
We designed an all-oral regimen of etoposide and cyclophosphamide for use in advanced non-small-cell lung cancer.
Eligible patients were chemotherapy-naive and had histologically confirmed assessable or measurable stage IV non-small-cell lung cancer. Patients received etoposide 50 mg/m2/d orally days 1 through 14 and cyclophosphamide 50 mg/m2/d orally days 1 through 14 every 28 days. Doses on later cycles were adjusted for myelosuppression.
Sixty-six patients (64 eligible patients) received 192 cycles of oral extended etoposide/cyclophosphamide therapy (median, two cycles; range, zero to 15). Therapy was well tolerated with the mean dose per cycle being 104% of the originally scheduled dose. Two patients (3%) achieved a complete response and six (9%) achieved a partial response. Leukopenia, anemia, nausea/vomiting, and alopecia were the most common toxicities. Median survival was 6 months, and the 1-year survival rate was 25.6%, comparable to more intensive treatments.
Oral extended etoposide/cyclophosphamide is a well-tolerated alternative for the treatment of stage IV non-small-cell lung cancer and can be used as a basis for the design of further outpatient regimens.
我们设计了一种依托泊苷和环磷酰胺的全口服方案，用于治疗晚期非小细胞肺癌。
符合条件的患者未曾接受过化疗，且经组织学确诊为可评估或可测量的IV期非小细胞肺癌。患者每28天接受依托泊苷50mg/m²/d口服，第1至14天；环磷酰胺50mg/m²/d口服，第1至14天。后续周期的剂量根据骨髓抑制情况进行调整。
66例患者（64例符合条件）接受了192周期的口服延长依托泊苷/环磷酰胺治疗（中位数为2个周期；范围为0至15个周期）。治疗耐受性良好，每个周期的平均剂量为原计划剂量的104%。2例患者（3%）达到完全缓解，6例（9%）达到部分缓解。白细胞减少、贫血、恶心/呕吐和脱发是最常见的毒性反应。中位生存期为6个月，1年生存率为25.6%，与更强化的治疗相当。
口服延长依托泊苷/环磷酰胺是治疗IV期非小细胞肺癌耐受性良好的替代方案，可作为进一步门诊治疗方案设计的基础。
