Pearson A D, Craft A W, Pinkerton C R, Meller S T, Reid M M
Department of Child Health, University of Newcastle upon Tyne, U.K.
Eur J Cancer. 1992;28A(10):1654-9. doi: 10.1016/0959-8049(92)90062-7.
In a high-dose schedule for disseminated neuroblastoma, eight courses of chemotherapy were administered every 10 days, regardless of myelosuppression, to eradicate tumour cells rapidly and reduce emergence of drug-resistant clones. Relatively non-myelotoxic vincristine and cisplatin were alternated with high-dose cisplatin-etoposide and cyclophosphamide-etoposide. Of 12 evaluable patients, there were 1 complete (CR), 3 very good partial (VGPR), 5 partial (PR) and 3 mixed responses (MR) 100 days after starting treatment. 6 out of 9 achieved a bone marrow CR at 40 days. 9 of 11 primary tumours were completely resected, after which 4 patients had CR, 3 VGPR (bone scan alone being abnormal), 4 PR and 1 mixed response (MR). Myelotoxicity was the major adverse effect. The only death was due to fungal infection. Clinically important renal dysfunction occurred in 3 patients. 4 had convulsions and 4 temporary hypertension. This schedule produced a rapid response and its toxicity, though serious, was manageable. Further evaluation is warranted.
在针对播散性神经母细胞瘤的高剂量化疗方案中，每10天进行8个疗程的化疗，无论是否存在骨髓抑制，目的是迅速根除肿瘤细胞并减少耐药克隆的出现。相对非骨髓毒性的长春新碱和顺铂与高剂量顺铂-依托泊苷及环磷酰胺-依托泊苷交替使用。在12例可评估的患者中，开始治疗100天后有1例完全缓解（CR）、3例非常好的部分缓解（VGPR）、5例部分缓解（PR）和3例混合缓解（MR）。9例中有6例在40天时达到骨髓CR。11例原发性肿瘤中有9例完全切除，之后4例患者达到CR，3例VGPR（仅骨扫描异常），4例PR和1例混合缓解（MR）。骨髓毒性是主要的不良反应。唯一的死亡是由于真菌感染。3例患者出现具有临床意义的肾功能障碍。4例发生惊厥，4例出现短暂性高血压。该方案产生了快速反应，其毒性虽然严重，但可以控制。有必要进行进一步评估。
