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[109例成人软组织肉瘤患者对化疗的反应]

[Responses of 109 adult soft tissue sarcoma patients to chemotherapy].

作者信息

Qiu Miao-Zhen, Xu Fei, Wang Shu-Sen, Luo Hui-Yan, Wang Feng, Li Fang-Hua, Sun Xiao-Fei, Xu Guang-Chuan, Lin Tong-Yu, Huang Hui-Qiang, Jiang Wen-Qi, Guan Zhong-Zhen, Xu Rui-Hua

机构信息

State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, PR China.

出版信息

Ai Zheng. 2007 Dec;26(12):1344-9.

Abstract

BACKGROUND & OBJECTIVE: The response of adult soft tissue sarcoma (STS) to chemotherapy is uncertain. This study was to evaluate the role of chemotherapy in treating adult soft tissue sarcoma.

METHODS

Clinical data of 109 adult soft tissue sarcoma patients, treated with chemotherapy at Cancer Center of Sun Yat-sen University from Jan. 2000 to Dec. 2005, were analyzed.

RESULTS

Of the 109 patients, 66 received palliative chemotherapy, 40 received adjuvant chemotherapy, and 3 received neoadjuvant chemotherapy. The overall response rate for first line chemotherapy was 22.7%. The median survival was 16.9 months. The 1-and 2-year survival rates were 63.6% and 33.3%. The patients with lung metastasis had a significantly longer median survival than those with liver metastasis did (25.1 months vs. 11.8 months, P<0.05). MAID and CYVADIC were the most commonly used first-line chemotherapy regimens; the response rates were 28.0% and 22.2%, respectively. When anthracycline and/or standard dose ifosfamide failed, the patients could still benefit from high dose ifosfamide (14.0 g/m(2)). The median survival was significantly shorter in the patients who got metastasis within 6 months after diagnosis than in those that got metastasis more than 6 months after diagnosis (11.8 months vs. 42.9 months, P=0.04). Of the 40 patients who received adjuvant chemotherapy, 16 developed progression during follow-up: 10 had relapse and 6 had distant metastasis.

CONCLUSIONS

MAID and CYVADIC are two effective chemotherapy regimens for adult soft tissue sarcoma. We recommend to take a high dose ifosfamide when anthracycline and/or standard dose ifosfamide failed. The patients with liver metastasis are more resistant to chemotherapy than those with lung metastasis. Developing metastasis within 6 months after diagnosis is a poor prognostic factor.

摘要

背景与目的

成人软组织肉瘤(STS)对化疗的反应尚不确定。本研究旨在评估化疗在成人软组织肉瘤治疗中的作用。

方法

分析2000年1月至2005年12月在中山大学肿瘤防治中心接受化疗的109例成人软组织肉瘤患者的临床资料。

结果

109例患者中,66例接受姑息化疗,40例接受辅助化疗,3例接受新辅助化疗。一线化疗的总有效率为22.7%。中位生存期为16.9个月。1年和2年生存率分别为63.6%和33.3%。肺转移患者的中位生存期明显长于肝转移患者(25.1个月对11.8个月,P<0.05)。MAID和CYVADIC是最常用的一线化疗方案;有效率分别为28.0%和22.2%。当蒽环类药物和/或标准剂量异环磷酰胺治疗失败时,患者仍可从高剂量异环磷酰胺(14.0 g/m²)中获益。诊断后6个月内发生转移的患者中位生存期明显短于诊断后6个月以上发生转移的患者(11.8个月对42.9个月,P=0.04)。40例接受辅助化疗的患者中,16例在随访期间病情进展:10例复发,6例远处转移。

结论

MAID和CYVADIC是成人软组织肉瘤的两种有效化疗方案。我们建议在蒽环类药物和/或标准剂量异环磷酰胺治疗失败时采用高剂量异环磷酰胺。肝转移患者比肺转移患者对化疗更耐药。诊断后6个月内发生转移是一个不良预后因素。

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