摘要
复发或难治的SCLC预后差 ,化疗对其缓解率低 ,中位生存时间为 4个月[1 ] 。广泛期的所有患者或局限期的大多数患者 ,肿瘤进展后需要二线化疗。对于复发的SCLC ,仍有多种药物具有抗肿瘤活性 ,如紫杉类的紫杉醇 (PTX)、泰索帝 ,拓扑异构酶Ⅰ的抑制剂拓扑替康 (TPT)、伊立替康 (CPT 11) ,异环磷酰胺、足叶乙苷 (VP 16 )、顺铂及卡铂等。复发或转移后的二线化疗尚无公认的统一标准治疗。目前应用较多的化疗方案包括 :TPT单药化疗 ,TPT +PDD ,TPT +IFO ,TPT +PTX等的联合化疗 ;CPT 11+IFO、CPT 11+PDD、CPT 11+CBP、CPT 11+PDD +VP 16的联合化疗 ;PTX +CBP、PTX +IFO的联合化疗 ;国内应用HCPT代替TPT及CPT 11联合化疗等。含阿霉素的联合化疗 ,在铂类及VP 16失败后几乎无效。
Relapsed SCLC has a low response rate to chemotherapy and an approximate four months median survival.All patients with extensive disease and most patients with limited disease will experience disease progression and become candidates for second-line therapy.A number of agents have demonstrated antitumor activity in relapsed SCLC,including paclitaxel,docetaxel,topotecan,irinotecan,ifosfamide,etoposide,cisplatin,and carboplatin.No standard chemotherapy in relapsed SCLC at present,TPT monotherapy and in novel combination regimens,such as TPT+PDD、TPT+IFO、TPT+PTX;irinotecan-based therapy including CPT-11+IFO、CPT-11+PDD、CPT-11+CBP、CPT-11+PDD+VP-16;PTX+CBP、PTX+IFO,and substitution of HCPT for TPT and CPT-11.Doxorubicin-containing combinations are rarely active in platinum/etoposide failures.
出处
《癌症进展》
2004年第4期277-281,共5页
Oncology Progress
关键词
小细胞肺癌
二线化疗
SCLC second line(sl)chemotherapy
