Bafaloukos D, Aravantinos G, Samonis G, Katsifis G, Bakoyiannis C, Skarlos D, Kosmidis P
Second Department of Medical Oncology, Metaxa's Cancer Hospital of Piraeus, Greece.
Oncology. 1999 Apr;56(3):198-201. doi: 10.1159/000011965.
Twenty-three patients with advanced or recurrent endometrial carcinoma entered a prospective study of chemotherapy which consisted of carboplatin (300 mg/m2), methotrexate (30 mg/m2), and 5-fluoruracil (500 mg/m2) given on day 1, in a 3-weekly schedule, in combination with medroxyprogesterone acetate (MPA): 300 mg daily, p. o., until progression (JMF-M regimen). None had received prior chemotherapy and/or hormonotherapy for metastatic disease. Ten patients had received radiotherapy. Response to treatment was evaluated every two courses. Objective response was seen in 17 of the 23 patients (74%, 95% confidence interval = 52-90%), with 2 long-lasting complete responses (9%). The median response duration was 10+ months (3-45+). The median survival was 16+ months (2-45+). The 2 complete responders, the first in the lung and the second in groin nodes, are without evidence or recurrence after 32 and 45 months, respectively. The regimen was given on an outpatient basis and was well tolerated. The major toxic effects were myelosuppression (less than 14% leukopenia, anemia and thrombocytopenia). The MPA-related side effects were: weight gain (22%), hypertension (17%) and thromboplebitis (17%). In 2 patients, consolidation treatment with MPA was discontinued because of thromboplebitis. In conclusion, the JMF-M regimen is highly active with an acceptable toxicity in patients with recurrent or metastatic endometrial carcinoma.
23例晚期或复发性子宫内膜癌患者进入一项化疗前瞻性研究,化疗方案为第1天给予卡铂(300mg/m²)、甲氨蝶呤(30mg/m²)和5-氟尿嘧啶(500mg/m²),每3周一次,联合醋酸甲羟孕酮(MPA):口服300mg/d,直至病情进展(JMF-M方案)。所有患者此前均未接受过针对转移性疾病的化疗和/或激素治疗。10例患者接受过放疗。每两个疗程评估一次治疗反应。23例患者中有17例出现客观反应(74%,95%置信区间=52-90%),其中2例为持久完全缓解(9%)。中位反应持续时间为10+个月(3-45+)。中位生存期为16+个月(2-45+)。2例完全缓解者,第一例肺部完全缓解,第二例腹股沟淋巴结完全缓解,分别在32个月和45个月后无疾病证据或复发。该方案在门诊实施,耐受性良好。主要毒副作用为骨髓抑制(白细胞减少、贫血和血小板减少均低于14%)。与MPA相关的副作用有:体重增加(22%)、高血压(17%)和血栓性静脉炎(17%)。2例患者因血栓性静脉炎而停止MPA巩固治疗。总之,JMF-M方案对复发性或转移性子宫内膜癌患者具有高活性且毒性可接受。