Kakolyris S, Samonis G, Koukourakis M, Vlachonicolis I, Chalkiadakis G, Kalbakis K, Souglakos I, Agelaki S, Toloudis P, Georgoulias V
Department of Medical Oncology, School of Medicine, University of Crete, Heraklion, Greece.
Am J Clin Oncol. 1998 Oct;21(5):505-8. doi: 10.1097/00000421-199810000-00018.
The efficacy and toxicity of chronic administration of oral etoposide was evaluated in 61 patients with inoperable non-small-cell lung cancer (NSCLC). Ten patients received previous chemotherapy, 15 received radiotherapy, and one received both treatments. Twenty-four patients had concurrent cardiac and/or pulmonary impairment, which precluded more intensive treatment. Etoposide was given orally, 100 mg daily for 7 consecutive days and consequently 100 mg every other day for 14 more days in a 28-day schedule. Partial response was observed in 17 patients (28%; 95% confidence interval, 17-39%) and stable disease in 21 (34%). The median duration of response was 6 months (range, 2-34 months). The median survival for responders was 22 months and that of nonresponders was 7 months (p < 0.001). The median survival for all patients was 9 months (range, 1-35 months; 95% confidence interval, 5.69-12.31%). Toxicity was acceptable. Other than alopecia, which was observed in all patients, myelotoxicity was the most common toxicity--particularly leukopenia, which was severe in nine patients. Other less common toxicities included nausea and vomiting, stomatitis, anorexia, and neurotoxicity and were mild. No treatment-related deaths were observed. In conclusion, the regimen was effective and well tolerated with significant survival benefit for the responders. It represents an interesting therapeutic approach, especially in the elderly.
对61例无法手术的非小细胞肺癌（NSCLC）患者评估了口服依托泊苷长期给药的疗效和毒性。10例患者先前接受过化疗，15例接受过放疗，1例两种治疗都接受过。24例患者同时存在心脏和/或肺部功能损害，这使得无法进行更强化的治疗。依托泊苷口服给药，每天100mg，连续7天，随后在28天的疗程中每隔一天给药100mg，共14天。17例患者（28%；95%置信区间，17 - 39%）观察到部分缓解，21例（34%）病情稳定。缓解的中位持续时间为6个月（范围，2 - 34个月）。缓解者的中位生存期为22个月，未缓解者为7个月（p < 0.001）。所有患者的中位生存期为9个月（范围，1 - 35个月；95%置信区间，5.69 - 12.31%）。毒性是可接受的。除了所有患者均出现的脱发外，骨髓毒性是最常见的毒性——尤其是白细胞减少，9例患者较为严重。其他不太常见的毒性包括恶心、呕吐、口腔炎、厌食和神经毒性，且症状较轻。未观察到与治疗相关的死亡。总之，该方案有效且耐受性良好，对缓解者有显著的生存获益。它代表了一种有趣的治疗方法，尤其是对老年人而言。
