Gogas H, Lofts F J, Evans T R, Millard F J, Wilson R, Mansi J L
Oncology Department, St George's Hospital, London, UK.
Br J Cancer. 1997;76(5):639-42. doi: 10.1038/bjc.1997.438.
To assess the efficacy and toxicity of an outpatient combination chemotherapy in small-cell lung cancer (SCLC), we treated 70 consecutive patients with epirubicin 80 mg m(-2) i.v. on day 1 and etoposide 200 mg o.d. p.o. on days 1-4 (EE) at 3-weekly intervals. The median age of patients was 64 years (range 39-84). The male-female ratio was 42:28 and 35 (50%) had metastatic disease. Fifty-seven patients were evaluable for response. The overall response rate was 64.4%, including 14 (23.7%) complete responses and 24 (40.7%) partial responses. Median time to progression was 7 months in responders and 8 months in patients with limited disease. The median survival in patients with limited disease was 10.5 months (range 0.5-70 +) and 7 months (range 0.5-24) in those with extensive disease. Improvement of symptoms occurred in 79% of patients with shortness of breath, 80% with cough, 81% with haemoptysis and 68% with pain. In 19 patients an increase in body weight was noted. Major (WHO grade 3/4) toxicities were neutropenia in 13 (18.5%) patients, alopecia in 33 (47.1%) patients, mucositis in 15 (21.4%) patients, anorexia in eight patients (11.4%), nausea and vomiting in six patients (8.5%) and diarrhoea in 4 (5.7%) patients. In conclusion, EE is an active and well-tolerated outpatient regimen in the treatment of SCLC. The survival data in this unselected group of patients were disappointing and the possible explanations for this are discussed.
为评估门诊联合化疗方案治疗小细胞肺癌（SCLC）的疗效及毒性，我们对70例连续患者进行了治疗，第1天静脉注射表柔比星80mg/m²，第1 - 4天口服依托泊苷200mg/日（EE方案），每3周为1个周期。患者的中位年龄为64岁（范围39 - 84岁）。男女比例为42:28，35例（50%）有转移性疾病。57例患者可评估疗效。总缓解率为64.4%，包括14例（23.7%）完全缓解和24例（40.7%）部分缓解。缓解者的中位疾病进展时间为7个月，局限期患者为8个月。局限期患者的中位生存期为10.5个月（范围0.5 - 70 +），广泛期患者为7个月（范围0.5 - 24）。79%气短患者、80%咳嗽患者、81%咯血患者及68%疼痛患者的症状得到改善。19例患者体重增加。主要（WHO 3/4级）毒性反应为：13例（18.5%）患者出现中性粒细胞减少，33例（47.1%）患者出现脱发，15例（21.4%）患者出现黏膜炎，8例（11.4%）患者出现厌食，6例（8.5%）患者出现恶心和呕吐，4例（5.7%）患者出现腹泻。总之，EE方案是治疗SCLC的一种有效的、耐受性良好的门诊治疗方案。本文讨论了这组未经选择的患者生存数据令人失望的可能原因。
