Bonomi P
Rush Presbyterian-St Lukes, Department of Oncology, Chicago, IL 60612, USA.
Semin Oncol. 1998 Aug;25(4 Suppl 9):70-8.
Approximately 25 years ago, investigators realized that small cell lung cancer was relatively sensitive to chemotherapy. The results of the initial trials showed that median survival duration in extensive-disease patients treated with combination chemotherapy was 8 to 10 months compared with 6 to 8 weeks for untreated patients. Similarly, in limited-disease patients, treatment with combination chemotherapy was associated with a median survival duration of approximately 12 months, while the median survival was approximately 3 to 4 months in patients treated with surgery or radiation therapy alone. Encouraged by the relatively high response rates and improved survival, investigators have conducted a large number of randomized trials that have tested concepts such as the Goldie-Coldman hypothesis and practical issues including chemotherapy dose and schedule, duration of treatment, and combined modality treatment. Selected randomized trials that have addressed important issues will be discussed in this brief review.
大约25年前，研究人员意识到小细胞肺癌对化疗相对敏感。最初试验的结果显示，接受联合化疗的广泛期患者的中位生存期为8至10个月，而未接受治疗的患者为6至8周。同样，在局限期患者中，联合化疗的中位生存期约为12个月，而仅接受手术或放疗的患者中位生存期约为3至4个月。受相对较高的缓解率和生存期改善的鼓舞，研究人员进行了大量随机试验，这些试验检验了诸如戈迪-戈德曼假说等概念以及包括化疗剂量和方案、治疗持续时间和综合治疗模式等实际问题。本简要综述将讨论一些解决了重要问题的随机试验。
