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局部晚期或转移性肉瘤患者接受序贯大剂量化疗后进行自体移植。

Tandem high-dose chemotherapy followed by autologous transplantation in patients with locally advanced or metastatic sarcoma.

作者信息

Lashkari Ashkan, Chow Warren A, Valdes Frances, Leong Lucille, Phan Vu, Twardowski Przemyslaw, Kapoor Neena, Molina Arturo, Al-Kadhimi Zaid, Frankel Paul, Somlo George

机构信息

City of Hope Comprehensive Cancer Center, Division of Medical Oncology, 1500 E. Duarte Road, Duarte, CA 91010, USA.

出版信息

Anticancer Res. 2009 Aug;29(8):3281-8.

Abstract

BACKGROUND

Patients with locally advanced or metastatic/recurrent soft tissue and Ewing's sarcoma (EWS) have few treatment options. The purpose of our phase II study was to assess the feasibility, safety and efficacy of tandem high-dose chemotherapy (HDCT) followed by autologous stem cell transplantation (ASCT) in such patients.

PATIENTS AND METHODS

Thirteen patients were enrolled onto this study. The first cycle of HDCT consisted of doxorubicin (150 mg/m(2)) and ifosfamide (14 g/m(2)) mixed with mesna (14 g/m(2)), while the second cycle consisted of melphalan (150 mg/m(2)) and cisplatin (200 mg/m(2)).

RESULTS

Eleven out of 13 patients were able to complete both cycles of HDCT. No treatment-related mortality occurred and grade 3 or 4 toxicity was clinically tolerable. The 5-year progression-free survival (PFS) and overall survival (OS) for all patients was 23% (confidence interval, CI: 0-46%) and 31% (CI: 14-70%), respectively. Out of the four patients still alive, two had EWS and measurable disease at the time of ASCT and achieved a complete remission, remaining progression free 126 and 155 months after ASCT.

CONCLUSION

Our study demonstrates the feasibility and safety of tandem HDCT in patients with high-risk or metastatic/recurrent sarcoma, with some patients achieving long-term PFS and OS.

摘要

背景

局部晚期或转移性/复发性软组织和尤因肉瘤(EWS)患者的治疗选择有限。我们这项II期研究的目的是评估串联大剂量化疗(HDCT)继以自体干细胞移植(ASCT)在此类患者中的可行性、安全性和疗效。

患者与方法

13例患者入组本研究。HDCT的第一个周期由阿霉素(150mg/m²)和异环磷酰胺(14g/m²)与美司钠(14g/m²)混合组成,而第二个周期由美法仑(150mg/m²)和顺铂(200mg/m²)组成。

结果

13例患者中有11例能够完成两个周期的HDCT。未发生与治疗相关的死亡,3级或4级毒性在临床上可耐受。所有患者的5年无进展生存期(PFS)和总生存期(OS)分别为23%(置信区间,CI:0 - 46%)和31%(CI:14 - 70%)。在仍存活的4例患者中,2例在ASCT时患有EWS且疾病可测量,并实现了完全缓解,在ASCT后分别无进展存活126个月和155个月。

结论

我们的研究证明了串联HDCT在高危或转移性/复发性肉瘤患者中的可行性和安全性,一些患者实现了长期的PFS和OS。

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