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진행성 비소세포폐암에서 Cisplatin과 Etoposide가 포함된 3제 복합항암화학요법의 결과
권정혜,신종욱,김재열,정형원,박인원,최병휘,이상재,손동섭,허성호 중앙대학교 의과대학 의과학연구소 2001 中央醫大誌 Vol.26 No.3
Purpose:Treatment of non-small cell lung cancer(NSCLC)have made modest prolongation of survial and improvement in quality of life. Although many studies have tried to treat the non-small cell lung cancer with combination chemotherapy based on cisplatin and etoposide, it remains to be certain what kind of assitional drugs and schedules can be applied. Thus, we conducted this study to assess the therapeutic effects of three different chemotheraeputic regimens, all containing cisplatin and etoposide, in patients with advanced NSCLC. Materias and Methoods: Eighty patients were enrolled who had histologically confirmed NSCLC with advanced stage, normal renal and bone marrow function. Sixteen patients were treated with FVP(cisplatin 20 mg/㎟ i.v. days 1∼5, etoposide 60mg/㎡ i.v. days 1∼5, 5-fluorouracil 800mg/㎟ i.v. days 1∼5), 36 patients with CVP(cisplatin 60mg/㎡ i.v. day 1, etoposide 80g/㎡ i.v. days 1∼5, cyclophosphamide 1000mg/㎡ i.v. day 1), and 28 patients with VIP(cisplatin 20mg/㎟ i.v. days 1∼5, etoposide 60mg/㎡ i.v. days 1∼5, ifosfamide1000mg/㎡ i.v. day 1∼5). Each cycle was repected every 3 or 4 weeks. We evaluated response rates, duration of remission, survival time, treatment-related toxicity and prognostic factors for survival. Results: One patient treated with VIP showed complete respose. Response rate of FVP(37.5%) and VIP(39.3%) were significantly higher than that of CVP(16.7%)(p=0.04). Median duration of remission was not significantly different among three groups(FVP14.9, CVP5.8, VIP7.3 months). No significant difference was found in overall median survival time among three groups(16.0 momths in FVP,14.3in CVP,17.3 in VIPgroup). In respoders to each therapeutic regimen, median survival times of FVP(21.5 months),VIP(undefined were significantly prolonged than 9.3 months of CVP group(p=0.016). We found that divided administration of cisplatin had relieved severe nausea and vomiting. Finally, as a result of prognostic factor analysis with Coxs proportional hazard model, chemotherapy was found to be significant prognostic factor for survival benefit in advanced NSCLC. Conciusion: Higher response rate and significant prolongation of survival time had been acquired as results of addition of ifosfamide or 5-fluorouracil to cisplatin and etoposide-based chemotherapy. In accordance with these data,it is warranted to conduct further prospective randomized study with combination of cisplatin, etoposide, ifosfamide and 5-fluorouracil.