Zucali Paolo Andrea, Bertuzzi Alexia, Parra Hector Jose Soto, Campagnoli Elisabetta, Quagliuolo Vittorio, Santoro Armando
Department of Medical Oncology and Hematology, Istituto Clinico Humanitas, Via Manzoni, 56 Rozzano, Milan, 20089, Italy.
Invest New Drugs. 2008 Apr;26(2):175-81. doi: 10.1007/s10637-007-9086-z. Epub 2007 Sep 25.
The aim of this study was to evaluate retrospectively the response rate, progression-free survival and median duration of response to dacarbazine as second/third-line chemotherapy for refractory soft tissue sarcomas. We studied 40 valuable patients with refractory soft tissue sarcomas and confirmed progressive disease (median age 54 years; range 24-73) treated between May 1997 and October 2005: 30 (75%) with metastases, and 23 (57.5%) with grade 3 disease. Dacarbazine was given as second-line chemotherapy to 29 patients (72.5%) every 21 days using three different schedules: dacarbazine 800 mg/m2 on day 1 (26 patients); dacarbazine 400 mg/m2 on days 1 and 2 (five patients); and dacarbazine 300 mg/m2 on days 1, 2 and 3 (nine patients). There were no complete responses, three (7.5%) partial responses and five (12.5%) cases of stable disease, for an overall disease control rate of 20%. Median progression-free survival was 2 months and median response duration 9 months. The 3- and 6-month progression-free rates were, respectively, 25% (SE 6.85%) and 20% (SE 6.32%). There were no cases of grade 3-4 hematological and non-hematological toxicity. In conclusion, our results suggest that second/third-line therapy with dacarbazine leads to satisfactory disease control in refractory soft tissue sarcomas; its activity seems to be comparable with other treatments, such as high dose ifosfamide or ecteinascidin-743, but it has a better toxicity profile.
本研究的目的是回顾性评估达卡巴嗪作为难治性软组织肉瘤二线/三线化疗的缓解率、无进展生存期和中位缓解持续时间。我们研究了1997年5月至2005年10月期间治疗的40例有价值的难治性软组织肉瘤且确诊为疾病进展的患者（中位年龄54岁；范围24 - 73岁）：30例（75%）有转移，23例（57.5%）为3级疾病。29例患者（72.5%）接受达卡巴嗪作为二线化疗，每21天使用三种不同方案：第1天给予达卡巴嗪800mg/m²（26例患者）；第1天和第2天给予达卡巴嗪400mg/m²（5例患者）；第1天、第2天和第3天给予达卡巴嗪300mg/m²（9例患者）。无完全缓解，3例（7.5%）部分缓解，5例（12.5%）疾病稳定，总疾病控制率为20%。中位无进展生存期为2个月，中位缓解持续时间为9个月。3个月和6个月的无进展率分别为25%（标准误6.85%）和20%（标准误6.32%）。无3 - 4级血液学和非血液学毒性病例。总之，我们的结果表明，达卡巴嗪二线/三线治疗为难治性软组织肉瘤带来了令人满意的疾病控制；其活性似乎与其他治疗相当，如高剂量异环磷酰胺或埃博霉素 - 743，但毒性谱更好。
