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作者报道了Sloan-Kettering纪念癌症中心62例局限期小细胞肺癌,均经病理证实,能接受综合治疗。肿瘤局限在同侧胸腔、纵隔、可伴有同侧或对侧锁骨上区淋巴结转移,但无胸腔积液。1979～1982年36例局限期小细胞肺癌用预防性脑照射,由于缺乏有效的证据及副作用增加,1985～1989年26例局限期小细胞肺癌屏除了预防性脑照射,但中枢神经系统转移显著增加,促使作者对预防性脑照射作用的重新评价。预防性脑照射(+)和预防性脑照射(-)两组均用CAV(CTX,ADR和VCR)和C-DDP+VP-16交替诱导化疗四周期。预防性脑照射(+)给予CTX和VCR巩固化疗,两组维持化疗亦用CAV与C-DDP+VP-16交替应用。预防性脑照射(+)加用CCNU,MTX和PCZ化疗。预防性脑放射(-)完成诱导化疗1周后,对CR和
The authors reported on 62 cases of limited-stage small cell lung cancer at the Sloan-Kettering Memorial Cancer Center. All patients were confirmed by pathology and were able to receive comprehensive treatment. The tumor is confined to the ipsilateral thorax, mediastinum, and can be accompanied by ipsilateral or contralateral supraclavicular lymph node metastases, but no pleural effusion. From 1979 to 1982, 36 patients with limited-stage SCLC were treated with prophylactic brain irradiation. Due to lack of effective evidence and increased side-effects, 26 cases of limited-stage SCLC screened in addition to prophylactic brain irradiation from 1985 to 1989, but the CNS metastasis was significant. The increase prompted the authors to re-evaluate the role of prophylactic brain irradiation. Both prophylactic brain irradiation (+) and prophylactic brain irradiation (-) received four cycles of CAV (CTX, ADR and VCR) and C-DDP+VP-16 alternating induction chemotherapy. Prophylactic brain irradiation (+) was given CTX and VCR consolidation chemotherapy, and maintenance chemotherapy was also alternated between CAV and C-DDP+VP-16. Prophylactic brain irradiation (+) plus CCNU, MTX, and PCZ chemotherapy. Prophylactic brain radiation (-) completed induction chemotherapy 1 week after CR and