Felip E, Del Campo J M, Bodi R, Vera R, Casado S, Rubio D
Department of Oncology, Hospital General Universitari Vall d'Hebron, Barcelona, Spain.
Am J Clin Oncol. 1997 Aug;20(4):404-6. doi: 10.1097/00000421-199708000-00017.
Combined chemotherapy/radiotherapy treatments appear to yield better results in locally advanced non-small-cell lung cancer (NSCLC) than radiotherapy alone. The optimal induction chemotherapy regimen remains to be established. In the present study, chemotherapy with cisplatin and vinorelbine was used prior to radical radiotherapy in Stage III-B NSCLC. Thirty-three patients were entered prospectively into a Phase II study. Treatment consisted of three cycles of chemotherapy with cisplatin 100 mg/m2 on day 1 and vinorelbine 30 mg/m2 on days 1 and 8, followed by thoracic radiotherapy (60 Gy). Twenty-two percent of the 33 patients had grade 3-4 leukopenia, and there were six episodes (in 4 patients) of neutropenia-associated fever. Gastrointestinal toxicity was generally moderate. Peripheral neuropathy was present in 42% of the patients, although in most of them it was slight. The main radiotherapy toxicity was esophagitis grade I-II. Evaluation of response after the third chemotherapy course showed an objective response in 16 patients (48%), whereas in three patients (9%) the disease progressed during therapy. The median survival of the entire group was 13 months. Cisplatin plus vinorelbine followed by radiotherapy is an effective schedule for patients with locally advanced non-small-cell lung cancer.
对于局部晚期非小细胞肺癌（NSCLC），联合化疗/放疗似乎比单纯放疗能产生更好的效果。最佳诱导化疗方案仍有待确定。在本研究中，对于ⅢB期NSCLC患者，在根治性放疗前使用顺铂和长春瑞滨进行化疗。33例患者前瞻性地进入一项Ⅱ期研究。治疗包括三个周期的化疗，第1天给予顺铂100mg/m²，第1天和第8天给予长春瑞滨30mg/m²，随后进行胸部放疗（60Gy）。33例患者中有22%出现3-4级白细胞减少，有6例（4例患者）出现中性粒细胞减少相关发热。胃肠道毒性一般为中度。42%的患者存在周围神经病变，不过大多数患者症状较轻。主要的放疗毒性为Ⅰ-Ⅱ级食管炎。第三个化疗疗程后的疗效评估显示，16例患者（48%）有客观反应，而3例患者（9%）在治疗期间疾病进展。整个组的中位生存期为13个月。顺铂加长春瑞滨后进行放疗，对于局部晚期非小细胞肺癌患者是一种有效的治疗方案。
