Medical Treatment of Lung Cancer 2000.12.8

Medical Treatment of Lung Cancer 2000.12.8

Bronchial lung cancer is divided into two types: ① small cell lung cancer (SCLC): oat cell, rhomboid cell, polygonal cell; ② non-small cell (NSCLC): squamous, adenocarcinoma, large cell.

This disease ranks first among cancer incidences in urban areas and fourth in rural areas, following stomach, esophageal, and gynecological cancers, with a male-to-female ratio of 2:1. Treatment principles: Whether small cell or non-small cell, the general principle is early detection and early treatment, striving for surgical resection of the primary tumor whenever possible. Small cell cases are often diagnosed at intermediate or late stages, making surgery unsuitable, so chemotherapy is preferred; if brain metastasis occurs, radiotherapy and intrathecal injections can be used, and for bone metastasis, ^89^ strontium and ^153^ samarium can be employed. Non-small cell cases should prioritize surgical resection, with routine preoperative and postoperative chemotherapy generally recommended.

Combined chemotherapy regimens: SCLC: For limited-stage disease (no metastasis), the response rate can reach 80%–90%, with a CR rate of 50%–60% and a median survival of 12–14 months. For extensive-stage disease, the response rate is 70%–80%, with a CR rate of 15%–30% and a median survival of 7–10 months. Common chemotherapy regimens include: ① CE regimen: Carboplatin (CPB) 300mg/㎡, intravenous drip, day 1–1, Vp-16 60–100mg, day 1–4, 28 days per cycle, three cycles per course. ② CAP regimen: CTX 500mg, day 1–8, ADM 40mg, day 2–4, DDP 30mg, day 2–4, three weeks per cycle, three cycles per course. ③ EAP regimen: ADM 30mg, day 1–1, Vp-16 100mg, day 2–5, DDP 30mg, day 5–7.

NSCLC chemotherapy: EPD regimen: ADM 30mg, day 1–1, Vp-16 100mg, day 1–4, DDP 20mg, day 2–4; NP regimen: Vinorelbine (NVB) 25mg/㎡2, day 1–8, adding 0.9% sodium chloride solution 250mL injected, followed by intravenous DXM 5–10mg, then flushing the vein with saline to prevent phlebitis; DDP 30mg, intravenous drip dz-40. This regimen has three weeks per cycle, three cycles per course. NIP regimen: NVB 25mg/㎡, day 1–8, ifosfamide (IFO) 1000mg, day 1–5, DDP 30mg, intravenous drip, day 5–7. This regimen has three weeks per cycle, three cycles per course. GP regimen: Gemcitabine (GEM) 1000mg, day 1–8–15, DDP 30mg, intravenous drip, day 2–4, four weeks per cycle, three cycles per course. In summary, three weeks per cycle, three cycles per course.