RANDOMIZED TRIAL OF CYCLOPHOSPHAMIDE, DOXORUBICIN, AND VINCRISTINE VERSUS CISPLATIN AND ETOPOSIDE VERSUS ALTERNATION OF THESE REGIMENS IN SMALL-CELL LUNG-CANCER

被引:364
作者
FUKUOKA, M
FURUSE, K
SAIJO, N
NISHIWAKI, Y
IKEGAMI, H
TAMURA, T
SHIMOYAMA, M
SUEMASU, K
机构
[1] OSAKA PREFECTURAL HABIKINO HOSP,DEPT INTERNAL MED,HABIKINO,OSAKA,JAPAN
[2] NATL KINKI CENT HOSP CHEST DIS,DEPT INTERNAL MED,SAKAI,OSAKA,JAPAN
[3] NATL CANC CTR,DEPT INTERNAL MED,K SUEMASU,TOKYO 104,JAPAN
[4] NATL CANC CTR,DEPT THORAC SURG,TOKYO 104,JAPAN
[5] NATL MATSUDO HOSP,DEPT INTERNAL MED,MATSUDO,CHIBA,JAPAN
[6] CTR ADULT DIS,DEPT RESP DIS,HIGASHI KU,OSAKA 537,JAPAN
关键词
D O I
10.1093/jnci/83.12.855
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Between April 1985 and May 1988, we conducted a randomized study comparing two standard chemotherapy regimens with the same regimens given on an alternating basis in patients with small-cell lung cancer. The patients were randomly assigned to receive cyclophosphamide at a dose of 800 mg/m2 intravenously (IV) on day 1, doxorubicin at 50 mg/m2 IV on day 1, and vincristine at 1.4 mg/m2 IV on day 1 (CAV); cisplatin at 80 mg/m2 IV on day 1 and etoposide at 100 mg/m2 IV on days 1, 3, and 5 (PE); or CAV alternating with PE (CAV/PE). Each regimen was repeated every 3-4 weeks. Three hundred patients were entered in the study, and 288 of them were eligible for analysis (97 for CAV, 97 for PE, and 94 for CAV/PE). The response rates for PE (78%) and CAV/PE (76%) were significantly higher than the rate for CAV (55%), while the complete response rates were similar (14%, 16%, and 15%, respectively). Nine (23%) of 39 patients who failed to respond to the initial CAV regimen responded to PE when they were crossed over. In contrast, only one (8%) of 13 patients responded to CAV after failing to respond to the PE regimen, suggesting that these two regimens were partially non-cross-resistant. The response duration on CAV/PE was significantly longer than that with CAV (P = .004). The survival time with CAV/PE (11.8 months) was superior to that with CAV (9.9 months) (P = .027) or that with PE (9.9 months) (P = .056). In patients with limited disease, the survival in the alternating arm was significantly superior to the survival in the CAV arm (P = .014) or the survival in the PE arm (P = .023). The toxic effects were acceptable in all three chemotherapy regimens. These results favor the alternating chemotherapy over either standard chemotherapy, such as CAV and PE, although the differences are not dramatic.
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收藏
页码:855 / 861
页数:7
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