Müge AKPINAR, Kunter PERİM, Emel ÇELİKTEN, Semra BİLAÇEROĞLU, Melih BÜYÜKŞİRİN

Küçük hücreli akciğer kanserinde alternan kemoterapinin etkinliği

1992-1995 yılları arasında, hastanemizde küçük hücreli akciğer kanseri (KHAK) tanısı alan, "Eastern Cooperative Oncology Group (ECOG)"un perfomans skalasına göre 0-3. derecede yer alan, hastalığın yaygın ve sınırlı oluşuna göre gruplandırılmış, 30 erkek olguda alternan kemoterapinin ekinliği ve güvenilirliğini değerlendirmeyi amaçladık. Olgulara ilk siklusta ifosfamid + doksorubusin + vinkristin (İDV), 2. siklusta sisplatin + etoposid (PE) uygulandı. Bu alternan tedavi, 21 gün arayla 6 kür verildi. Radyolojik yanıt, her kemoterapi kürü sonrasında ve tedavinin sonlanmasından 1 ay sonra Dünya Sağlık Örgütü (DSÖ)'nün belirlediği kriterlere göre değerlendirildi. Tam yanıt %23.3, kısmi yanıt %16.6, stabilite %26.7 olmak üzere toplam yanıt oranı (tam + kısmi + stabil) %66.6, progresyon ise %33.4 idi. Yanıt alınan grubun performansının kemoterapi öncesi iyi olduğu (0-1. derece) ve kemoterapi sonrası sürdüğü ancak yanıt alınamayan grupta kemoterapi sonrası performansın kötüleştiği izlendi. Hastalığın yaygınlığına göre sınırlı olgularda yanıt %73.6 yaygınlarda ise %54.5 idi. Bir olguda görülen lökopeni dışında önemli bir yan etki izlenmedi. Bu bulgularla, KHAK'da İDV/PE alternan tedavisinin etkin ve emniyetli olabileceği kanısına varılmıştır. Ancak çalışmamızda karşılaştırmalı bir metod izlenmeyişi ve sınırlı sayıda hasta nedeniyle, İDV/PE rejiminin daha ileri çalışmalarla incelenmesi yerinde olacaktır.

Efficiency of cyclic alternating chemotherapy in small cell cancer

The aim of the study was to assess the efficiency and safety of alternating chemotherapy in 30 male cases diagnosed with small cell lung carcinoma (SCLC) between 1992-1995. The cases were of 0-3 performance status according to the Eastern Cooperative Oncology Group (ECOG) and were gruped as extensive or limited disease. Ifosfamide + doxorubicin + vincristine (IDV) and cisplatin + etoposide (PE) were edminestered as the first two courses, respectively; this alternating therapy was given upto 6 courses with 21-day episodes in between. Radiologic responce was assessed after each course and 1 month after the completion of chemotherapy, according to the criteria which the World Health Organization (WHO) has established. Complete, partial, stable, total response and progression rates were; 23.3%, 16.6%, 26.7%, 66.6% and 33.4%, respectively. It was observed that, prechemotherapy performance of the responding group was good (0-1) and was maintained after chemotherapy whereas postchemotherapy performance of the unresponsive group worsened. When assessed according to the extension of the disease, response rate was 73.6% in limited stage, and 54.5% in extensive stage. Other than leucopenia in one case, no significant side effects were encountered. With these findings, it was concluded that alternating chemotherapy with IDV/PE could be efficient and safe in SCLC. However, owing to the lack of a comparative design and a limited number of patients in our trial, further trials are needed to study the IDV/PE regimen.

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