Stables G I, Doherty V R, MacKie R M
University Department of Dermatology, Western Infirmary, Glasgow, U.K.
Br J Dermatol. 1992 Nov;127(5):505-8. doi: 10.1111/j.1365-2133.1992.tb14849.x.
During the 9-year period from 1982 to 1991, 72 patients with melanoma were treated with a 5-day quadruple drug chemotherapy regime (BELD) comprising bleomycin, vindesine (Eldesine), CCNU (Lomustine) and DTIC. Forty-three patients had stage III melanoma, 34 of whom had evaluable disease. Of these 34, six (17.6%) achieved a complete response (CR), eight (23.5%) had a partial response (PR), five (14.7%) had stabilized disease (SD) and 15 (44.1%) had progressive disease (PD). Overall median survival of stage III melanoma patients was 38 weeks. Median survival of responders (CR + PR) was 47 weeks and 21 weeks for non-responders (SD + PD) (P < 0.005). Median follow-up time was 38 weeks. Following these encouraging results, 30 patients with stage II melanoma received BELD chemotherapy as adjuvant therapy after regional node dissection and clearance. Adjuvant BELD chemotherapy did not alter survival in these patients. BELD combination chemotherapy is well-tolerated, the main problems being nausea, vomiting, and leucopenia. We have maintained a combined response rate (CR + PR) of 41.1% for stage III disease. This is comparable with other combination chemotherapy regimes, which have as yet not been superseded by the newer biological therapies.
在1982年至1991年的9年期间，72例黑色素瘤患者接受了为期5天的四联药物化疗方案（BELD），该方案包括博来霉素、长春地辛（长春花碱酰胺）、洛莫司汀（环己亚硝脲）和达卡巴嗪。43例患者为III期黑色素瘤，其中34例有可评估的病情。在这34例患者中，6例（17.6%）达到完全缓解（CR），8例（23.5%）部分缓解（PR），5例（14.7%）病情稳定（SD），15例（44.1%）病情进展（PD）。III期黑色素瘤患者的总体中位生存期为38周。缓解者（CR + PR）的中位生存期为47周，未缓解者（SD + PD）为21周（P < 0.005）。中位随访时间为38周。基于这些令人鼓舞的结果，30例II期黑色素瘤患者在区域淋巴结清扫术后接受了BELD化疗作为辅助治疗。辅助性BELD化疗并未改变这些患者的生存期。BELD联合化疗耐受性良好，主要问题是恶心、呕吐和白细胞减少。对于III期疾病，我们维持了41.1%的联合缓解率（CR + PR）。这与其他联合化疗方案相当，而这些方案尚未被更新的生物疗法所取代。
