Late intensive combined modality therapy followed by autologous bone marrow infusion in extensive-stage small-cell lung cancer.
Late intensive combined modality therapy followed by autologous bone marrow infusion in extensive-stage small-cell lung cancer.
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广泛期小细胞肺癌的晚期强化联合治疗，随后进行自体骨髓输注。
DOI：
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发表时间：
1986
影响因子：
45.3
通讯作者：
R. Abrams
中科院分区：
文献类型：
--
作者：
D. Ihde;A. Deisseroth;A. Lichter;P. Bunn;D. Carney;M. Cohen;S. Veach;R. Makuch;A. Johnston‐Early;R. Abrams
为了改善广泛期小细胞肺癌（SCLC）患者的不良预后，我们尝试对常规化疗12周后肿瘤消退良好的患者进行晚期强化联合治疗（LICMRX）。29例连续大分期SCLC患者接受6周环磷酰胺、甲氨蝶呤和洛莫司汀（CMC）诱导治疗，随后接受6周长春新碱、阿霉素和丙卡嗪（VAP）治疗。对身体状况良好、完全缓解（CR）或部分缓解（PR）、骨髓检查无肿瘤的患者，在重新放置评估肿瘤反应后，采集其自体骨髓（ABM）。LICMRX包括以2000 rad分5次照射5天，照射到最初的肿瘤累及部位，随后使用环磷酰胺60 mg/kg照射2天，依托泊苷200 mg/m2照射3天，然后输注ABM。此后给予预防性颅脑照射（PCI），但未再使用化疗。由于缺乏肿瘤消退或医疗条件差，最初的29例患者中只有10例符合LICMRX；2人拒绝，因此只有8人（28%）接受了治疗。3例在CR中开始使用LICMRX的患者在另外4个月、8个月和15个月后出现SCLC复发。在5例PR患者中，1例达到CR，但在3个月时复发，2例保持PR，在2和4个月时进展，2例死于感染，未从LICMRX中恢复。在6例存活患者中，从输注ABM到粒细胞计数恢复到500/微升的平均时间为15.8天（范围12-22）。LICMRX的主要非血液学毒性是严重的食管炎。在所有29例患者中，有6例CR(21%)，没有2年生存率，相比之下，78例既往接受CMC + VAP治疗的大分期患者的CR率为36%，2年生存率为10%，未使用LICMRX。我们得出结论，本研究中给予的LICMRX只能用于少数大分期SCLC患者，并且不太可能对2年生存率产生实质性改善（2年生存率的95%置信限为0%至10%）。
To attempt to improve the poor prognosis of extensive-stage small-cell lung cancer (SCLC) patients, we tried to administer late intensive combined modality therapy (LICMRX) to patients with good tumor regression after 12 weeks of conventional chemotherapy. Twenty-nine consecutive extensive-stage SCLC patients received 6 weeks of cyclophosphamide, methotrexate, and lomustine (CMC) induction therapy, followed by 6 weeks of vincristine, doxorubicin, and procarbazine (VAP). After restaging for assessment of tumor response, autologous bone marrow (ABM) was collected in patients in good medical condition with complete response (CR) or partial response (PR) and no tumor on marrow examination. LICMRX consisted of irradiation with 2,000 rad in five fractions for five days to sites of initial tumor involvement, followed by cyclophosphamide, 60 mg/kg for 2 days, and etoposide, 200 mg/m2 for 3 days and then by ABM infusion. Prophylactic cranial irradiation (PCI) was administered thereafter, but no further chemotherapy was used. Due to lack of tumor regression or poor medical condition, only ten of the original 29 patients were eligible for LICMRX; two refused, so only eight (28%) received therapy. Three patients who began LICMRX in CR developed recurrence of SCLC after an additional 4, 8, and 15 months. Of five patients with PR, one attained CR but relapsed at 3 months, two remained in PR and progressed at 2 and 4 months, and two died of infection without recovery from LICMRX. Mean time from ABM infusion to recovery of granulocyte count to 500/microL was 15.8 days in the six surviving patients (range, 12-22). The major non-hematologic toxicity of LICMRX was severe esophagitis. Among all 29 patients, there were six CRs (21%) and no 2-year survivors, compared with a CR rate of 36% and 10% 2-year survivors in 78 extensive-stage patients previously treated with CMC plus VAP without LICMRX. We conclude that the LICMRX given in this study can be administered to only a minority of extensive-stage SCLC patients and is very unlikely to yield substantial improvement in the fraction of 2-year survivors (95% confidence limits for 2-year survival 0% to 10%).
自体骨髓支持的高剂量强化治疗限制性小细胞支气管癌。
DOI：
10.1200/jco.1986.4.1.4
发表时间：
1986
期刊：
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
影响因子：
--
作者：
Spitzer,G;Farha,P;Valdivieso,M;Dicke,K;Zander,A;Vellekoop,L;Murphy,WK;Dhingra,HM;Umsawasdi,T;Chiuten,D
通讯作者：
Chiuten,D
自体骨髓移植强化放化疗治疗小细胞肺癌。
DOI：
--
发表时间：
1983
期刊：
Cancer treatment reports
影响因子：
--
作者：
Stewart,P;Buckner,CD;Thomas,ED;Bagley,C;Bensinger,W;Clift,RA;Appelbaum,FR;Sanders,J
通讯作者：
Sanders,J