100例局限期小细胞肺癌疗效

100例局限期(LD)小细胞肺癌(SCLC),用COM、COF、COM-Cc(COF-Cc)或COM-Cc-VP诱导化疗,继以局部放疗和/或脑预防放疗(PBI),并继续化疗,争取总治程达2年。CR 40％(40/100)、CR+PR 94％(94/100)。中数生存期16月,达CR者21月。2、3、5年生存期概率分别为43％、33％及23％。现6例>5-9年仍生存,3例已34—41月仍CR中,1例CR者于81月死于急性心肌梗塞。3药与≥4药诱导化疗疗效、年生存率、年缓解率无差别。CR者之2、3、5年生存率,及缓解率均优于PR者。诱导化疗并局部放疗后,继续化疗>6次(约24周)者:CR者的2、3年生存率,及PR者之1、2年生存率,均显著优于≤6次化疗者(P<0.01、<0.01,70.05、<0.05)。PBI者脑转移率与PBI(-)者无差别,但MST、2、3年生存率优于PBI(-)者(P<0.005、<0.001、<0.005)。Zubrod ECOG—WHO全身状况计分0—1者,CR、CR+PR及2、3、5年生存期,均显著优于2—3分者(P<0.01、<0.01、=0.003、=0.004及=0.02)。性别对疗效、生存率无影响。本组毒性均轻到中度,无与化疗有关之死亡。

THE RESULTS OF TREATMENT IN 100 PATIENTS WITH LIMITED STAGE SMALL CELL LUNG CANCER

100 patients with limited-stage SCLC were treated with induction chemotherapy regimens of COM, COF, COM-Cc or COM-Cc-Vp, and thoracic irradiation or PBI.CR was 40% (40/100), CR+PR was 94% (94/100). MST was 16 months, and 21 months for complete responders. 2-,3-, and 5-years propability survival rate was 43%,33% and 23%. Nine patientes are still alive with CR for more than 34-108 months. One of the complete responders died of acute myocardial infraction in the eighty-first month from the onset of the treatment.The complete response and good performance staias are still the important factors for long survival. There were no differences of remission and survival rates between 3-drug or 4-drug induction chemotherapy. After finishing induction chemotherapy and chest irradiation, it seemed that both of complete responders and partial responders, who continued to receive more than six cycles of chemotherapy had much better survival than those with 6 or less cycles of treatments. Brain metastatic rate was not different in patients with or without PBI, but the 2-and 3-year survival of patients with PBI was significant longer than those without PBI.