Kindler H L, Kris M G, Smith I E, Miller V A, Grant S C, Krebs J B, Ross G A, Slevin M L
Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Am J Clin Oncol. 1998 Oct;21(5):438-41. doi: 10.1097/00000421-199810000-00003.
Topotecan (9-dimethylaminoethyl-10-hydroxycamptothecin) is a topoisomerase I inhibitor. Twenty-six patients with stage IIIB or IV non-small-cell lung cancer (NSCLC) who had received no prior chemotherapy were treated in a multicenter study with topotecan 0.6 mg/m2/day for 21 days by continuous intravenous infusion every 28 days; this starting dose was decreased to 0.5 mg/m2/day in the last 23 patients because of myelosuppression. There was one partial response, for a response rate of 4% (95% confidence interval, 0.1%-19.6%). Median survival was 9 months. One-year survival was 39%. Of the 58 lung cancer symptoms at baseline, 40% were resolved by the end of best response (all in the partial response patient, 62% in stable disease patients, 26% in progressive disease patients). Catheter-related infections complicated 19% of courses. Red-cell transfusions were given in 50% of courses. Toxicity included grade 4 neutropenia (4%), grade 3-4 anemia (19%), grade 4 thrombocytopenia (8%), and catheter-related infections (19% courses). Although the major objective response rate was only 4%, patients treated with topotecan given as a 21-day continuous intravenous infusion experienced a decrease in cancer-related symptoms and a 1-year survival of 39%.
拓扑替康（9 - 二甲基氨基乙基 - 10 - 羟基喜树碱）是一种拓扑异构酶I抑制剂。在一项多中心研究中，对26例未经前期化疗的IIIB期或IV期非小细胞肺癌（NSCLC）患者，每28天持续静脉输注拓扑替康0.6 mg/m²/天，共21天；由于骨髓抑制，后23例患者的起始剂量降至0.5 mg/m²/天。有1例部分缓解，缓解率为4%（95%置信区间，0.1% - 19.6%）。中位生存期为9个月。1年生存率为39%。在基线时的58种肺癌症状中，40%在最佳反应结束时得到缓解（全部在部分缓解患者中，疾病稳定患者中为62%，疾病进展患者中为26%）。19%的疗程出现导管相关感染。50%的疗程给予红细胞输注。毒性包括4级中性粒细胞减少（4%）、3 - 4级贫血（19%）、4级血小板减少（8%）和导管相关感染（19%的疗程）。尽管主要客观缓解率仅为4%，但接受拓扑替康21天持续静脉输注治疗的患者癌症相关症状有所减轻，1年生存率为39%。
