小细胞肺癌最新最全治疗方案
英汉对照（原创翻译） ，麻烦指正。原文来自：medscape。
小细胞癌治疗方案
作者: Marvaretta M Stevenson, MD;
Treatment protocols for small cell lung cancer (SCLC) are provided below, including first-line therapy, therapy for limited-stage disease, and therapy for extensive-stage disease.
SCLC治疗方案见下，包括一线治疗、局限期治疗和广泛期治疗。
Treatment recommendations for limited-stage SCLC
Stages I-III disease:
局限期SCLC治疗推荐
I-III期
Limited-stage disease is typically treated with a combination of chemotherapy and radiation(concurrently)
局限期的标准治疗是同步化放疗
Sequential therapy can also be given for limited-stage disease for patients unable to tolerate concurrent chemoradiation; chemotherapy is given first, followed by radiation therapy because of the high rate of responsiveness to chemotherapy for SCLC
若病人不能耐受同步化放疗则给予以下治疗：首先化疗，然后化疗，因为SCLC对化疗有较高的反应率。
T3-4 tumors due to multiple ipsilateral lung nodules are treated as extensive-stage disease
Concurrent chemotherapy recommendationswith radiation for limited-stage diseaseinclude the following:
有多个同侧肺结节T3-4期肿瘤按广泛期治疗。
Cisplatin 60 mg/m2 IV on day 1 plus etoposide 120 mg/m2 IV on days 1-3 every 21d for 4 cyclesor
Cisplatin 80 mg/m2 IV on day 1 plus etoposide 100 mg/m2 IV on days 1-3 every 28d for 4 cycles
顺铂60 mg/m2 IV d1 VP16 120 mg/m2 IV days 1-3 ，21天为1周期共4周期或
顺铂80 mg/m2 IV day 1 VP16 100 mg/m2 IV days 1-3 28天为1周期共4周期
Radiotherapy for limited-stage disease should start with cycle 1 or 2 of chemotherapy
局限期1或2个化疗周期后开始放疗。
Chemotherapy recommendations for patients not able to tolerate concurrent chemotherapy and radiation:
不能耐受同步化放疗者化疗的推荐
Patients with limited-stage (stages I–III) disease who are not able to tolerate chemotherapy and radiation concurrently should be treated with chemotherapy as first-line therapy
局限期（I–III期）不能耐受同步放化疗者化疗作为一线治疗
Cisplatin 60-80 mg/m2 IV on day 1 plus etoposide 80-120 mg/m2 IV on days 1-3 every 21-28d (maximum of 4 cycles)
顺铂60-80 mg/m2 IV day 1+VP16 80-120 mg/m2 IV days 1-3 ，每21-28d 为一疗程(最多4疗程)
Or或
Carboplatin AUC 5-6 IV on day 1 plus etoposide 80-100 mg/m2 IV on days 1-3 every 28d (maximum of 4 cycles)
卡铂AUC 5-6 IV on day 1+VP16 80-100 mg/m2 IV on days 1-3，每28天为1疗程（最多4疗程）
First-line chemotherapy for extensive-stage disease
Stage IV disease:
广泛期一线化疗
IV期
The following treatment recommendations should be given for a maximum of 4-6 cycles:
下述推荐方案最多4-6疗程：
Cisplatin 60-80 mg/m2 IV on day 1 plus etoposide 80-120 mg/m2 IV on days 1-3 every 21-28dor
顺铂60-80 mg/m2 IV day 1+VP16 80-120 mg/m2 IV days 1-3 ，每21-28d 为一疗程
或
Carboplatin AUC 5-6 IV on day 1 plus etoposide 80-100 mg/m2 IV on days 1-3 every 28dor
卡铂AUC 5-6 IV on day 1+VP16 80-100 mg/m2 IV on days 1-3，每28天为1疗程
或
Cisplatin 60 mg/m2 IV on day 1 plus irinotecan 60 mg/m2 IV on days 1, 8, and 15 every 28dor
顺铂60 mg/m2 IV on day 1+伊力替康60 mg/m2 IV on days 1, 8, 15，每28天为一疗程。
或
Cisplatin 30 mg/m2 IV on days 1 and 8 or 80 mg/m2 IV on day 1 plus irinotecan 65 mg/m2 IV on days 1 and 8 every 21dor
顺铂30 mg/m2 IV on days 1 ，8 或80 mg/m2 IV on day 1+伊力替康65 mg/m2 IV on days 1 ，8 ，每21d为一疗程。或
Carboplatin AUC 5 IV on day 1 plus irinotecan 50 mg/m2 IV on days 1, 8, and 15 every 28dor
卡铂AUC 5 IV on day 1+伊力替康50 mg/m2 IV on days 1, 8, 15 ，每28d为一疗程。或
Carboplatin AUC 4-5 IV on day 1 plus irinotecan 150-200 mg/m2 IV on day 1 every 21dor
卡铂AUC 4-5 IV on day 1+伊力替康150-200 mg/m2 IV on day 1 ，每21天为一疗程。或[
Cyclophosphamide 800-1000 mg/m2 IV on day 1 plus doxorubicin 40-50 mg/m2 IV on day 1 plus vincristine 1-1.4 mg/m2 IV on day 1 every 21-28d
环磷酰胺800-1000 mg/m2 IV on day 1+多柔比星40-50 mg/m2 IV on day 1+长春新碱1-1.4 mg/m2 IV on day 1，每21-28天为一疗程。
Second-line chemotherapy for relapsed or refractory disease
Stage IV disease :
复发或难治性患者的2线化疗方案
IV期
Second-line chemotherapy is given for at least 4-6 cycles but can be given until disease progression as tolerated in some cases
2线化疗方案至少应用4-5周期；如果可以耐受也可以一直用至疾病进展
Patients who have relapsed disease more than 6mo after completing first-line chemotherapy can be treated with that original first-line regimen (typically a platinum-based doublet) again, with and expected response rate of 62-100%
完成一线化疗6各月后复发者可以再用原一线化疗方案（基础铂类加倍），预期反应率62-100%。
Etoposide 50 mg/m2 PO daily for 3wk every 4wkor
VP1650 mg/m2 PO daily 共3周，每4周为一周期，或
Topotecan 2.3 mg/m2 PO on days 1-5 every 21dor
托普替康2.3 mg/m2 PO on days 1-5，每21天为一周期。或
Topotecan 1.5 mg/m2 IV on days 1-5 every 21dor
托普替康1.5 mg/m2 IV on days 1-5，每21d为1周期，或
Carboplatin AUC 5 IV on day 1 plus irinotecan 50 mg/m2 IV on days 1, 8, and 15 every 28dor
卡铂AUC 5 IV on day 1+伊力替康50 mg/m2 IV on days 1, 8，15。每28天一个周期，或
Carboplatin AUC 4 - 5 IV on day 1 plus irinotecan 150-200 mg/m2 IV on day 1 every 21dor
卡铂AUC 4 - 5 IV on day 1+伊力替康150-200 mg/m2 IV on day 1，每21天一个周期，或
Cisplatin 30 mg/m2 IV on days 1, 8, and 15 plus irinotecan 60 mg/m2 IV on days 1, 8, and 15 every 28dor
顺铂30 mg/m2 IV on days 1、8、15，+伊力替康60 mg/m2 IV on days 1、8、15 ，每28d一周期。或
Cisplatin 60 mg/m2 IV on day 1 plus irinotecan 60 mg/m2 IV on days 1, 8, and 15 every 28dor
顺铂60 mg/m2 IV on day 1+伊力替康60 mg/m2 IV on days 1、8、15，每28d一周期，或
Cisplatin 30 mg/m2 IV on days 1 and 8 or 80 mg/m2 IV on day 1 plus irinotecan 65 mg/m2 IV on days 1 and 8 every 21dor
顺铂30 mg/m2 IV on days 1 、8或80 mg/m2 IV on day 1+伊力替康65 mg/m2 IV on days 1 、8，每21天一周期。或
Paclitaxel 80 mg/m2 IV weekly for 6wk every 8wkor
多西他赛80 mg/m2 IV 每周共6周，8周为一周期。或
Paclitaxel 175 mg/m2 IV on day 1 every 3wk
多西他赛175 mg/m2 IV on day 1，每3周一周期。
Third-line chemotherapy for relapsed or refractory disease
Stage IV disease :
难治或复发者的三线化疗方案
Etoposide 50 mg/m2 PO daily for 3wk every 4wk or
VP16 50 mg/m2 每天口服共3周，每4周一个周期。或
Topotecan 2.3 mg/m2 PO on days 1-5 every 21d or
托普替康2.3 mg/m2 口服on days 1-5 ，每21d为一周期。或
Topotecan 1.5 mg/m2 IV on days 1-5 every 21d or
托普替康1.5 mg/m2 IV on days 1-5，每21d为一周期。或
Carboplatin AUC 5 IV on day 1 plus irinotecan 50 mg/m2 IV on days 1, 8, and 15 every 28d or
卡铂AUC 5 IV on day 1+伊力替康50 mg/m2 IV on days 1、8、15 ；每28d为一周期。或
Carboplatin AUC 4-5 IV on day 1 plus irinotecan 150-200 mg/m2 IV on day 1 every 21d or
卡铂AUC 4-5 IV on day 1+伊力替康150-200 mg/m2 IV on day 1，每21d一周期。或
Cisplatin 30 mg/m2 IV on days 1, 8, and 15 plus irinotecan 60 mg/m2 IV on days 1, 8, and 15 every 28d or
顺铂30 mg/m2 IV on days 1、8、15 +伊力替康60 mg/m2 IV on days 1、8、15 ，每28d一周期。或
Cisplatin 60 mg/m2 IV on day 1 plus irinotecan 60 mg/m2 IV on days 1, 8, and 15 every 28d or
顺铂60 mg/m2 IV on day 1 +伊力替康60 mg/m2 IV on days 1、8、15，每28d为一周期。或
Cisplatin 30 mg/m2 IV on days 1 and 8 or 80 mg/m2 IV on day 1 plus irinotecan 65 mg/m2 IV on days 1 and 8 every 21d or
顺铂30 mg/m2 IV on days 1、8 或80 mg/m2 IV on day 1 +伊力替康65 mg/m2 IV on days 1、8 ，每21d一周期，或
Paclitaxel 80 mg/m2 IV weekly for 6wk every 8wk or
紫杉醇80 mg/m2 IV 每周一次，共6周，每8周一周期。或
Paclitaxel 175 mg/m2 IV on day 1 every 3wk
紫杉醇175 mg/m2 IV on day 1，每3周一周期。
IRB-approved clinical trial
Special considerations
IRB—批准的临床试验
特别考虑
Patients with mixed SCLC/non-SCLC histology should be given the same treatment as patients with SCLC
小细胞和非小细胞混合组织类型按小细胞病人处理。
Prophylactic cranial irradiation is recommended for SCLC patients with a complete or partial remission (total of 25 Gy in 10 fractions or 30 Gy in 10-15 fractions)
达CR或PR的SCLC病人推荐预防性脑部放疗。
Dose dense or dose escalation chemotherapy regimens are not recommended outside of a randomized clinical trial
除非随机临床试验，不推荐剂量密度或剂量爬坡化疗方案。
Patients with brain metastases can receive chemotherapy prior to brain radiation due to high response rates with chemotherapy
脑转移者可先进行化疗然后进行脑部放疗，因为其对化疗有高反应率。 略有瑕疵：
1、有个笔误：
“Sequential therapy can also be given for limited-stage disease for patients unable to tolerate concurrent chemoradiation; chemotherapy is given first, followed by radiation therapy because of the high rate of responsiveness to chemotherapy for SCLC
若病人不能耐受同步化放疗则给予以下治疗：首先化疗，然后化疗，因为SCLC对化疗有较高的反应率。”
“首先化疗，然后放疗”
2、“T3-4 tumors due to multiple ipsilateral lung nodules are treated as extensive-stage disease
Concurrent chemotherapy recommendationswith radiation for limited-stage diseaseinclude the following:
有多个同侧肺结节T3-4期肿瘤按广泛期治疗。”
第二句“Concurrent chemotherapy recommendations with radiation for limited-stage disease include the following:”漏翻了，“局限期疾病的同步放化疗如下：”
3、笔误：
“Second-line chemotherapy is given for at least 4-6 cycles but can be given until disease progression as tolerated in some cases
2线化疗方案至少应用4-5周期；如果可以耐受也可以一直用至疾病进展”
“4-6周期”
4、“Prophylactic cranial irradiation is recommended for SCLC patients with a complete or partial remission (total of 25 Gy in 10 fractions or 30 Gy in 10-15 fractions)
达CR或PR的SCLC病人推荐预防性脑部放疗。”
括号内的放疗为“总量25Gy/10次或30Gy/10-15次” 谢谢你翻译的资料，有一个问题请教一下，这个资料来源于哪里？谢谢！ 丈夫一岁 发表于 2011-8-9 10:06 static/image/common/back.gif
谢谢你翻译的资料，有一个问题请教一下，这个资料来源于哪里？谢谢！
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