cis-Dichlorodiammineplatinum(II) and VP-16-213: an active induction regimen for small cell carcinoma of the lung.
cis-Dichlorodiammineplatinum(II) and VP-16-213: an active induction regimen for small cell carcinoma of the lung.
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顺式二氯二氨铂 (II) 和 VP-16-213：小细胞肺癌的主动诱导方案。
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发表时间：
1979
期刊：
影响因子：
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通讯作者：
R. Wittes
中科院分区：
文献类型：
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作者：
J. S. Sierocki;B. Hilaris;S. Hopfan;N. Martini;D. Barton;R. Golbey;R. Wittes
38例既往无治疗的小细胞癌患者接受联合化疗方案治疗，包括第1天和第22天静脉注射60 mg/m2顺式二氯二氨铂（II）（顺铂），第4、6、8、25、27和29天静脉注射120 mg/m2 VP-16-213。随后给予1000 mg/m2环磷酰胺、40 mg/m2阿霉素和1.4 mg/m2长春新碱，均在第42、63、84和105天静脉给药。然后再循环该程序，从第126天开始使用顺铂和VP-16-213，并重复上述方案。所有患者在第42天和第63天之间接受预防性全脑放疗（通常剂量为3000拉德，分10次）。如果没有复发，预计治疗持续时间为18个月。在21例局限性疾病患者中，完全缓解率为52%（5.75 ± 15.25+个月），部分缓解率为48%（2.25 ± 10.5个月）。广泛疾病组的完全缓解率为41%（4.75- 11+个月），部分缓解率为47%（3.75- 11.5+个月）。对顺铂和VP-16-213治疗的反应非常迅速，并且在6周诱导期结束时总是最大。有限疾病组的生存率似乎令人鼓舞，但随访时间不足。毒性包括恶心和呕吐、骨髓抑制、脱发和肾功能不全，这在2例患者中是剂量限制性的。顺铂和VP-16-213联合治疗显然是肺小细胞癌的一种有效诱导方案，但它是否会在提高长期生存率方面发挥作用仍有待观察。
Thirty-eight patients with small cell carcinoma and no prior therapy were treated with a combination chemotherapy program including 60 mg/m2 of cis-dichlorodiammineplatinum(II) (cis-platinum) iv on Days 1 and 22 and 120 mg/m2 of VP-16-213 iv on Days 4, 6, 8, 25, 27, and 29. This was followed by 1000 mg/m2 of cyclophosphamide, 40 mg/m2 of Adriamycin, and 1.4 mg/m2 of vincristine, all given iv on Days 42, 63, 84, and 105. The program was then recycled, with cis-platinum and VP-16-213 beginning on Day 126 and the regimen repeated as above. All patients received prophylactic whole-brain radiation (usually at a dose of 3000 rads in ten fractions) between Days 42 and 63. The projected duration of treatment is 18 months in the absence of relapse. In 21 patients with limited disease, the complete response rate was 52% (5.75+--15.25+ months) and the partial remission rate was 48% (2.25--10.5 months). The extensive-disease group showed a complete remission rate of 41% (4.75--11+ months) and a partial remission rate of 47% (3.75--11.5+ months). Response to therapy with cis-platinum and VP-16-213 was very rapid and invariably maximal by the end of the 6-week induction period. Survival for the limited-disease group appears encouraging but followup time is insufficient. Toxicity included nausea and vomiting, myelosuppression, alopecia, and renal insufficiency which was dose-limiting in two patients. The cis-platinum and VP-16-213 combination is clearly an active induction regimen in small cell carcinoma of the lung, but whether it will play a role in increasing long-term survival rates remains to be seen.