국소진행성 비소세포성 폐암에서 5-FU, Vinblastine 및 Cisplatin (FVP)의 수술전 선행 화학요법의 효과
The Effect of Neoadjuvant Chemotherapy with 5-Fluorouracil(5-FU), Vinblastine and Cisplatin (FVP) for Stage Ⅲ Non-Small Cell Lung Cancer(NSCLC)
대한암학회지 1997년 29권 5호 p.807 ~ 815
소속 상세정보
원정일/Jung Il Won
천종호/김형준/조문숙/김동규/곽영태/김정숙/최수전/김성록/Jong Ho Chun/Hyeong Jun Kim/Moon Suk Jo/Dong Kyu Kim/Young Tae Kwak/Jung Suk Kim/Soo Jeon Choi/Sung Rok Kim
KMID : 0360319970290050807
Abstract
결론
병기 Ⅲ 비소세포폐암 환자에서 5-fluorouracil, vinblastine, cisplatin (FVP) 선행 항암 약
물요법자 수술을 시행함으로써 절제율 38.5%, 2년 생존율 87%, 중앙생존기간 31개월을, 병
기 ⅢB에서 절제율 30%, 중앙생존기간 31개월을 유도한 바, 병기 Ⅲ, 특히 병기 ⅢB의 고
무적인 치료결과라고 생각되며, 향후 선행 항암 약물요법과 수술, 선행 항암 약물요법과 방
사선 치료 병용요법에 대한 제 3상 임상연구가 필요하리라 생각된다.
#초록#
Purpose : As the prognosis of stage Ⅲ NSCLC is still poor with or without operation,
we conducted a phase Ⅱ trial of neoadjuvant chemotherapy(CHT) with 5-FU,
vinblastine, cisplatin prior to surgery to determine the effect on resectability and
survival.
Materials and Method : Patients(pt) received 5-FU 500mg/m2/12 hours
continuous infusion for 36 hours, vinblastine 3mg/m2/day iv bolus day 1
and day 2, and cisplatin 75mg/m2 iv day 1 every 3 weeks. This regimen
was given for 2 cycles. When the tumor was responsive(stable disease or better), 1 or 2
more cycles of the CHT were given, followed by operation when totally resectable on
chest CT/MRI, then 3 more cycles of the CHT to finish the treatment; when the tumor
was neither responsive nor resectable after 3rd or 4th CHT, radiotherapy was started.
Result : Twenty nine pt were enrolled and 26 pt have been evaluable so far. Age
ranged from 32 to 79(median 59 years) 23 were male, 3 female. Total of 108 cycles
were given(mean 4.2). There were 4 partial remissions out of 6 ⅢAs(67%) and 10 out
of 20 ⅢBs(50%), with overall response rate of 53.8%; down staging was noted in 9
patients(34.6%). 9 pt(34.6%) underwent curative resection successfully; 4 out of 6 Ⅲ
As(67%) and 5 out of 20 ⅢBs(25.0%); 1 patient refused operation. Median survival was
31.3 months for 9 pt with operation, and that of all patients was 14.2 months. Radiation
was given to 9 pt, resulting in 3 partial remissions(PR), 3 stable diseases(SD), 3
progressive diseases(PD). Serious(WHO grade ≥ 3) toxicities were nausea/emesis in
2.8%, granulocytopenia in 26.9% and thrombocytopenia in 2.8%.
Conclusion : This treatment modality seemed to be effective, encouraging further
phase Ⅲ study for better determination of its role.
키워드
5-Fluorouracil; Vinblastine; Cisplatin; Neoadjuvant chemotherapy; Non-small cell lung cancer;
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