A randomized study of chemotherapy with cisplatin plus etoposide versus chemoendocrine therapy with cisplatin, etoposide and the pineal hormone melatonin as a first-line treatment of advanced non-small cell lung cancer patients in a poor clinical state

被引:77
作者
Lissoni, P
Paolorossi, F
Ardizzoia, A
Barni, S
Chilelli, M
Mancuso, M
Tancini, G
Conti, A
Maestroni, GJM
机构
[1] OSPED SAN GERARDO, DIV RADIOTERAPIA ONCOL, I-20052 MONZA, MILAN, ITALY
[2] IST PATOL, LOCARNO, SWITZERLAND
关键词
cisplatin; etoposide; lung cancer; melatonin;
D O I
10.1111/j.1600-079X.1997.tb00329.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Recent studies suggest that the pineal hormone melatonin may reduce chemotherapy-induced immune and bone marrow damage, In addition, melatonin may exert potential oncostatic effects either by stimulating host anticancer immune defenses or by inhibiting tumor growth factor production. On this basis, we have performed a randomized study of chemotherapy alone vs. chemotherapy plus melatonin in advanced nonsmall cell lung cancer patients (NSCLC) with poor clinical status. The study included 70 consecutive advanced NSCLC patients who were randomized to receive chemotherapy alone with cisplatin (20 mg/m(2)/day i.v. for 3 days) and etoposide (100 mg/m(2)/day i.v. for 3 days) or chemotherapy plus melatonin (20 mg/day orally in the evening). Cycles were repeated at 21-day intervals, Clinical response and toxicity were evaluated according to World Health Organization criteria. A complete response (CR) was achieved in 1/34 patients concomitantly treated with melatonin and in none of the patients receiving chemotherapy alone. Partial response (PR) occurred in 10/34 and in 6/36 patients treated with or without melatonin, respectively. Thus, the tumor response rate was higher in patients receiving melatonin (11/34 vs. 6/35), without, however, statistically significant differences. The percent of 1-year survival was significantly higher in patients treated with melatonin plus chemotherapy than in those who received chemotherapy alone (15/34 vs. 7/36, P < 0.05). Finally, chemotherapy was well tolerated in patients receiving melatonin, and in particular the frequency of myelosuppression, neuropathy, and cachexia was significantly lower in the melatonin group. This study shows that the concomitant administration of melatonin may improve the efficacy of chemotherapy, mainly in terms of survival time, and reduce chemotherapeutic toxicity in advanced NSCLC, at least in patients in poor clinical condition.
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页码:15 / 19
页数:5
相关论文
共 16 条
[1]  
Blask D.E., 1984, P253
[2]   The clinical neuroimmunotherapeutic role of melatonin in oncology [J].
Conti, A ;
Maestroni, GJM .
JOURNAL OF PINEAL RESEARCH, 1995, 19 (03) :103-110
[3]   MELATONIN MODULATES GROWTH-FACTOR ACTIVITY IN MCF-7 HUMAN BREAST-CANCER CELLS [J].
COS, S ;
BLASK, DE .
JOURNAL OF PINEAL RESEARCH, 1994, 17 (01) :25-32
[4]  
EHRKE MJ, 1989, SEMIN ONCOL, V16, P230
[5]  
KLASTERSKY J, 1985, SEMIN ONCOL, V12, P38
[6]  
LIN AY, 1992, JAMA-J AM MED ASSOC, V267, P536
[7]  
LISSONI P, 1991, J BIOL REG HOMEOS AG, V5, P154
[8]  
LISSONI P, 1994, J BIOL REG HOMEOS AG, V8, P126
[9]  
LISSONI P, 1992, ONCOLOGY-BASEL, V49, P336
[10]   ENDOCRINE AND IMMUNE EFFECTS OF MELATONIN THERAPY IN METASTATIC CANCER-PATIENTS [J].
LISSONI, P ;
BARNI, S ;
CRISPINO, S ;
TANCINI, G ;
FRASCHINI, F .
EUROPEAN JOURNAL OF CANCER & CLINICAL ONCOLOGY, 1989, 25 (05) :789-795