TREATMENT OF PATIENTS WITH SMALL CELL LUNG CANCER

A.一天两次放疗加VP-16和顺铂的方案 对于有限的阶段，小细胞肺癌仍在继续。44名患者 已经进入研究阶段，41名患者中有29名(71%) 完成治疗后，病情完全缓解。计划中的 中位生存期为24个月，中位潜在随访期超过 三年了。17名患者接受了活组织检查，因为他们试图进入 体外药敏试验。17人中有7人(42%)接受了治疗 使用体外确定的组合，这些患者存活了下来 中位数为39个月。 B.顺铂和依托泊苷在患者体内的剂量强度研究 继续进行广泛的阶段性研究。已经有83名患者被 随机接受VP-16 80 mg/m2，第1-3天， 顺铂80 mg/m2，第1天(43)或依托泊苷80 mg/m2。 顺铂27 mg/m2，第1-5天(40天)，前2个周期每3周一次 并在前6周后接受标准化疗。虽然 在接受更高剂量治疗的患者中，血液毒性增加。 顺铂剂量与依托泊苷完全缓解率无差异 高剂量和低剂量之间的比率、总应答率或存活率 手臂。试验已完成预提。剂量的前瞻性研究 依托泊苷顺铂治疗小细胞肺癌的速率强度没有变化 在接受多67%的化疗的患者中是否显示出生存优势 前六周的治疗。 C.针对胃泌素释放的单抗(2A11) 在小鼠中起自分泌生长因子作用的多肽(蛙皮素) 细胞肺癌已被用于治疗小细胞肺癌患者 癌症。已有12名患者接受了第二期剂量的 25mgm/m2。在完成治疗的10名患者中，有1名(10%) 以临床完全反应回应。这些计划将继续下去 去受审。

A. A protocol combining twice a day radiotherapy plus VP 16 and cisplatin for limited stage small cell lung cancer continues. Forty-four patients have been entered onto study and 29 of 41 (71%) patients who have completed therapy have achieved a complete remission. The projected median survival is 24 months with a median potential follow-up more than 3 years. Seventeen patients have undergone biopsy for attempts at in vitro drug sensitivity testing. Seven of the 17 (42%) have been treated with an in vitro determined combination and those patients have survived for a median 39 months. B. The study of dose intensity using cisplatin and etoposide in patients with extensive stage studies continues. Eighty-three patients have been randomized to receive either VP-16 80 mg/m2 on days 1-3 days with cisplatin 80 mg/m2 administered on day 1 (43) or etoposide 80 mg/m2 and cisplatin 27 mg/m2 on days 1-5 (40) every 3 weeks for the first 2 cycles and receive standard chemotherapy after the first 6 weeks. Although there is increased hematologic toxicity in patients treated with higher dose etoposide cisplatin, there is not difference in complete response rate, overall response rate, or survival between the high and low dose arm. The trial has completed accrual. This prospective study of dose rate intensity of etoposide cisplatin in small cell lung cancer does not show any survival advantage to administering 67% more chemotherapy in the first six weeks of treatment. C. A monoclonal antibody (2A11) directed against gastrin releasing peptide (bombesin) which functions as an autocrine growth factor in small cell lung cancer has been used to treat patients with small cell lung cancer. Twelve patients have been treated with the phase II dose of 25mgm/m2. One of the ten patients (10%) who completed therapy has responded with a clinical complete response. The plans are to continue to trial.