小细胞肺癌最新最全治疗方案

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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)[1]
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[2, 1]
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[1]
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 cycles[3]or
Cisplatin 80 mg/m2 IV on day 1 plus etoposide 100 mg/m2 IV on days 1-3 every 28d for 4 cycles[4]
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)[3, 4]
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)[5]
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 21-28d[6, 7, 8, 9, 10, 11, 12, 13]or
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 28d[13, 14, 15, 16]or
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 28d[8, 11, 12]or
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 21d[7, 9]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 28d[14, 16]or
卡铂AUC 5 IV on day 1+伊力替康50 mg/m2 IV on days 1, 8, 15 ，每28d为一疗程。或
Carboplatin AUC 4-5 IV on day 1 plus irinotecan 150-200 mg/m2 IV on day 1 every 21d[17, 18, 19]or
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[20, 21, 22]
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[7] :
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%[2, 1]
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 4wk[23]or
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 21d[24, 25, 26]or
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 21d[24, 25, 27]or
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 28d[14, 16]or
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 21d[17, 18, 19]or
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 28d[28]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[8, 12]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[7, 9]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21天一周期。或
Paclitaxel 80 mg/m2 IV weekly for 6wk every 8wk[29]or
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[30]
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[1] :
难治或复发者的三线化疗方案
Etoposide 50 mg/m2 PO daily for 3wk every 4wk[23] 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[24, 25, 26] 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[24, 25, 27] 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[14, 16] 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[17, 18, 19] 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[28] 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[8, 12] 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[7, 9] 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[29] 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[29]
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[1, 2]
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)[1, 2]
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[1, 2]

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[1, 2]

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。

gexiaom

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[2, 1]
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[1]
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)[1, 2]
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”

丈夫一岁

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！

gexiaom

丈夫一岁 发表于 2011-8-9 10:06
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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瑞秋ZZ

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