Oat cell carcinoma of the lung. Combination treatment with radiotherapy and cyclophosphamide, adriamycin, vincristine, and methotrexate
Oat cell carcinoma of the lung. Combination treatment with radiotherapy and cyclophosphamide, adriamycin, vincristine, and methotrexate
复制标题
肺燕麦细胞癌。
作者：
R. Wittes;S. Hopfan;Basil Hilaris;R. Golbey;M. Melamed;N. Martini
对肺燕麦细胞癌患者和既往未接受过化疗的患者，采用环磷酰胺1000 mg/m2静脉内（i. v.）第1天静脉注射阿霉素30 mg/m2，第1天静脉注射长春新碱1.4 mg/m2，第22天静脉注射甲氨蝶呤30 mg/m2。每个月都回收处理。对于大多数局部受累的患者，如果患者在转诊前未接受过放疗，则在化疗前接受放疗（60-Co 3000 R，10次治疗原发性、纵隔和临床受累的颈部淋巴结）。在29例对联合治疗的抗肿瘤应答可评价的患者中，83%显示肿瘤完全或部分（大于50%）消退;中位应答持续时间为8个月（范围1-16个月）。在15例最初接受化疗的患者中，80%的患者肿瘤完全或部分消退。从治疗开始的中位生存期为12个月的那些有限的疾病在介绍和8个月的那些表现为播散性疾病。随后所有主要器官部位均发生疾病进展，甚至包括既往放疗部位的肺和纵隔。剂量限制性毒性包括85%的白色血细胞计数<3000，5例败血症和2例死亡，12%的血小板计数<100，000，8例接受放疗和化疗的患者发生严重食管炎。Cancer 40：653-659，1977.
Patients with oat cell carcinoma of the lung and no prior chemotherapy were treated with a regimen composed of cyclophosphamide 1000 mg/m2 intravenously (i.v.) day 1, Adriamycin 30 mg/m2 i.v. day 1, vincristine 1.4 mg/m2 i.v. day 1, and methotrexate 30 mg/m2 i.v. day 22. Treatments were recycled every month. For most patients with locoregional involvement, radiation therapy (60‐Co 3000 R in 10 treatments to primary, mediastinum, and clinically involved cervical nodes) was given before chemotherapy, if the patient had not received radiation prior to the referral. Of 29 patients evaluable for an antitumor response to combined therapy, 83% showed complete or partial (greater than 50%) regression of tumor; the median duration of response was 8 months (range 1–16 months). Of 15 patients treated initially with chemotherapy, 80% had complete or partial regression of tumor. Median survival from start of therapy was 12 months for those with limited disease at presentation and 8 months for those presenting with disseminated disease. Subsequent progression of disease occurred in all major organ sites, even including lung and mediastinum which had been sites of prior radiotherapy. Dose‐limiting toxicities included white blood cell counts <3000 in 85%, with five cases of sepsis and two deaths, platelet counts <100,000 in 12%, and significant esophagitis in eight patients who received radiation therapy and chemotherapy in close temporal relation. Cancer 40:653–659, 1977.