소세포미분화폐암에서 VIP(VP-16-213, Ifosfamide, Cis-Platinum) 및 CAV(Cyclophosphamide, Adriamycin, Vincristine) 복합화학요법의 교대치료
Alternative Chemotherapy with VIP (VP-16, Ifosfamide, Cis-Platinum) and CAV (Cyclophosphamide, Adriamycin, Vincristine) in Small Cell Undifferentiated Lung Cancer
이순남, 허대석, 김노경, 심영수, 김건열, 한용철, 박찬일,
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이순남 ( )
이화여자대학교 의과대학 내과학교실
허대석 ( )
서울대학교 의과대학 내과학교실
김노경 ( )
서울대학교 의과대학 내과학교실
심영수 ( )
서울대학교 의과대학 내과학교실
김건열 ( )
서울대학교 의과대학 내과학교실
한용철 ( )
서울대학교 의과대학 내과학교실
박찬일 ( )
서울대학교 의과대학 치료방사선학교실
KMID : 0360319870190020079
Abstract
Non-cross resistant regimen consisting of VIP rapidly alternating with CAV has been studied in 45 patients with small cell lung cancer. VP-16 60 mg/㎡ i.v. on days 1-5, ifosfamide 1000 mg/㎡ i.v. on days 1-5, and cis-platinum 60 mg/㎡ i.v. on day 1 was alternated at interval of 3 weeks with cyclophosphamide 1000 mg/㎡ i.v. on day 1, adriamycin 45 mg/㎡ i.v. on day 1 and vincristine 1. 4 mg/㎡ i.v. on day 1. For 27 patients with limited disease, indution chemotherapy with one cycle of VIP and CAV was followed by radiotherapy to primary tumor, both supraclavicular lymph nodes and prophylactic whole brain irradiation. Three to four weeks after the completion of radiotherapy, 12 cycles of VIP and CAV were maintained. Eighteen patients with extensive disease were treated with chemotherapy alone. The results obtained were as follows;
1) A 92.6% overall response rate and 44.8% complete remission rate in limited disease and 61. 1% overall response rate and 11.1% complete remission rate in extensive disease were achieved. Overall resonse rate in both stage disease was 80.0% and the rate of complete and partial remission was 33.3% and 46.6% respectively.
2) The overall median duration of remission was 49.2 weeks. The median duration of remission was not reached in limited disease group (range, 4-92+weeks) and 34.5 weeks in extensive disease group. The duration of remission for the complete responders was much longer than that for the partial responders (p < 0.01).
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