TREATMENT OF PATIENTS WITH LUNG CANCER

肺癌生物科已经研究了长期服用 紫杉醇暴露于肺癌与二次发病的关系 北美一大群存活于小细胞的患者中的癌症 肺癌。 28个肺癌细胞系的研究随着时间的延长而增加。 暴露在紫杉醇中。紫杉醇所需浓度的中位数 抑制14例非小细胞肺癌(NSCLC)细胞生长50% 用四甲基偶氮唑盐比色法测得的谱线减少了1000多倍 暴露时间从3小时增加到120小时。中位紫杉醇 抑制小细胞肺癌细胞生长50%所需浓度 当曝光时间从3增加到120时，线条减少了10倍 几个小时。基于此，我们在体外进行了一项为期96小时的I期试验 先输注紫杉醇，再输注顺铂。50例患者 以前未经治疗的肺癌(42例非小细胞肺癌和8例小细胞肺癌)是 用递增剂量的紫杉醇治疗96小时 输注后增加顺铂的剂量。推荐阶段 II剂量为紫杉醇120毫克/米，每平方米80毫克 顺铂。剂量限制性毒性为血液学。42名患者 NSCLC的有效率为55%，中位生存期为10个月， 41%的患者在开始治疗后一年内存活。推荐的 第二阶段的剂量现在正在用于第二阶段的试验，患者患有 IV期和IIIb期(伴胸腔积液)非小细胞肺癌和新辅助试验 联合6000cGy胸部照射治疗IIIa期和 嘴唇。 一个来自10个机构的北美合作工作组确定了 611例小细胞癌治疗后存活两年或以上的患者 肺癌患者罹患第二种癌症87例，是其亲属的3.5倍 风险。这主要是由于患癌症的风险增加了11倍。 肺癌。这些患者12年的累积风险为30%。 胸部照射和持续吸烟导致了 风险增加。一项针对这一人群的化学预防试验 有条理的。

The Lung Cancer Biology Section has studied the effect of prolonged exposure of paclitaxel to lung cancer and the rate of developing second cancers in a large North American cohort of patients surviving small cell lung cancer. Twenty-eight lung cancer cell lines were studied with increasing durations of exposure to paclitaxel. The median paclitaxel concentration required to inhibit 50% of the growth of 14 non-small cell lung cancer (NSCLC) cell lines measured by MTT assay decreased more than 1000-fold when the exposure duration increased from 3 to 120 hours. The median paclitaxel concentration required to inhibit 50% of the cell growth of SCLC cell lines decreased 10-fold when the exposure duration increased from 3 to 120 hours. Based on this in vitro, we performed a phase I trial of a 96 hour infusion of paclitaxel followed by cisplatin. Fifty patients with previously untreated lung cancer (42 with NSCLC and 8 with SCLC) were treated with increasing doses of paclitaxel administered as a 96 hour infusion followed by increasing doses of cisplatin. The recommended phase II dose was 120 mg/m of paclitaxel and 80 mg per meter squared of cisplatin. The dose limiting toxicity was hematologic. The 42 patients with NSCLC had a response rate of 55%, a median survival of 10 months, and 41% were alive at one year after starting treatment. The recommended phase II dose is now being used in a phase II trial for patients with stage IV and IIIb (with pleural effusion) NSCLC and in a neoadjuvant trial combined with 6000 cGy of chest radiation for patients with stage IIIa and IIIb. A cooperative North American working group from 10 institutions identified 611 patients surviving two or more years after treatment for small cell lung cancer who developed 87 second cancers, a 3.5-fold increased relative risk. This was principally caused by an 11-fold increase in the risk of lung cancer. The cumulative risk at 12 years for these patients was 30%. Chest irradiation and continuing cigarette smoking contributed to the increased risk. A chemoprevention trial for this population has been organized.