Moriyama T, Miyazono N, Mukai H, Miyaji N, Inoue H, Oyama T, Nakajo M, Tanohata S
Department of Radiology, Kagoshima University, Japan.
Nihon Igaku Hoshasen Gakkai Zasshi. 1996 Feb;56(3):116-20.
Twenty-six patients with unresectable non-small cell lung cancer were treated by chemotherapy alone or chemotherapy followed by radiotherapy from June 1988 to May 1990. CDDP (80 mg/m2) was given by bronchial arterial infusion (BAI) on day 1 in each course, VP-16 (80 mg/body) was given by drip intravenous infusion on days 1 and 2, and VP-16 (150 mg/body) was given orally on days 3 and 5. The patients were irradiated after this regimen with a single dose of 1.8-2.0 Gy, five times each week, to a volume which encompassed only the primary tumor. A total dose of 60 Gy or more was delivered. There were 10 squamous cell carcinomas, nine adenocarcinomas, five large cell carcinomas, one adenosquamous cell carcinoma and one poorly differentiated carcinoma. Median survival time (MST) was 354 days in stage III B patients and 280 days in stage IV patients. MST was 155 days in adenocarcinoma and 310 days in squamous cell carcinoma. MST was 372 days in PS 0 to 1 patients and 140 days in PS 2 patients. With chemo-radiotherapy in 17 cases resulted in no complete remissions and 10 partial remissions. The overall response rate was 58.8%. It is concluded that CDDP via BAI combined with VP-16 administration and sequential irradiation is useful to acquire a high response rate in non-small cell lung cancer. However, further studies on this modality are required.
1988年6月至1990年5月期间，26例不可切除的非小细胞肺癌患者接受了单纯化疗或化疗后放疗。每个疗程第1天通过支气管动脉灌注（BAI）给予顺铂（80mg/m²），第1天和第2天通过静脉滴注给予依托泊苷（80mg/体），第3天和第5天口服依托泊苷（150mg/体）。在此方案后，患者接受单次剂量1.8 - 2.0Gy的照射，每周5次，照射体积仅包括原发肿瘤。总剂量达60Gy或更高。其中有10例鳞状细胞癌、9例腺癌、5例大细胞癌、1例腺鳞癌和1例低分化癌。ⅢB期患者的中位生存时间（MST）为354天，Ⅳ期患者为280天。腺癌患者的MST为155天，鳞状细胞癌患者为310天。PS 0至1级患者的MST为372天，PS 2级患者为140天。17例接受放化疗的患者无完全缓解，10例部分缓解。总缓解率为58.8%。结论是，通过BAI给予顺铂联合依托泊苷给药及序贯照射有助于在非小细胞肺癌中获得较高的缓解率。然而，需要对这种治疗方式进行进一步研究。
