VP-16 AND CISPLATIN AS 1ST-LINE THERAPY FOR SMALL-CELL LUNG-CANCER
VP-16 AND CISPLATIN AS 1ST-LINE THERAPY FOR SMALL-CELL LUNG-CANCER
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DOI：
10.1200/jco.1985.3.11.1471
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发表时间：
1985-01-01
影响因子：
45.3
通讯作者：
DEBOER, G
中科院分区：
文献类型：
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作者：
EVANS, WK;SHEPHERD, FA;DEBOER, G
31例小细胞肺癌(SCLC)患者采用VP-16和顺铂作为一线治疗方案。在大多数病例中，由于严重的心脏或肝脏疾病，含有阿霉素(阿德里亚实验室，俄亥俄州哥伦布市)的方案是禁忌的。8名表现为脑转移的患者也包括在这一系列研究中。局限性疾病(LD)11例，广泛性疾病(ED)20例。在28例可评价的患者中，12例(43%)完全缓解(CR)，12例(43%)部分缓解(PR)。4名患者(14%)要么无反应，要么治疗进展。LD患者的中位缓解期为39周，ED患者的中位缓解期为26周。完全缓解(CR)和完全缓解(PR)LD患者的中位生存期(MST)为70周(28~181+周)，有效ED患者的中位生存期为43周(17~68周)。胃肠道反应轻微，但白细胞减少和血小板减少是常见的。在药物引起的中性粒细胞减少期间有四次发热发作，导致一例与治疗相关的死亡。15名患者出现肾毒性，2名患者需要停用顺铂。这些结果与标准诱导化疗方案的报道相比是有利的，并为VP-16和顺铂方案在小细胞肺癌患者中的活性提供了进一步的证据。
Thirty-one patients with small-cell lung cancer (SCLC) were treated with VP-16 and cisplatin as first-line therapy. In the majority of cases an Adriamycin (Adria Laboratories, Columbus, Ohio) containing regimen was contraindicated because of severe cardiac or hepatic disease. Eight patients who presented with cerebral metastases were also included in the series. Eleven patients had limited disease (LD), and 20 had extensive disease (ED). Of the 28 evaluable patients, 12 (43%) achieved a complete response (CR) and 12 (43%) had a partial response (PR). Four patients (14%) either had no response or progressed on treatment. The median duration of response for patients with LD was 39 weeks and for those with ED, 26 weeks. The median survival time (MST) for the whole group of responding (CR and PR) LD patients was 70 weeks (range, 28 to 181 + weeks), and for responding ED patients, it was 43 weeks (range, 17 to 68 weeks). Gastrointestinal toxicity was mild, but leukopenia and thrombocytopenia were common. There were four febrile episodes during periods of drug induced neutropenia and this led to one treatment related death. Nephrotoxicity occurred in 15 patients and required discontinuation of cisplatin in two. These results compare favorably with reports of standard induction chemotherapy regimens and provide further evidence of the activity of the VP-16 and cisplatin regimen in patients with SCLC.