Roth B J, Sledge G W, Williams S D, Meyer S C, Ansari R, Fisher W B
Department of Medicine, Indiana University School of Medicine, Indianapolis.
Cancer. 1991 Jul 15;68(2):248-52. doi: 10.1002/1097-0142(19910715)68:2<248::aid-cncr2820680205>3.0.co;2-4.
Forty-six eligible patients with metastatic breast cancer (MBC) were treated with a combination of methotrexate, vinblastine, doxorubicin, and cisplatin (M-VAC) as first-line chemotherapy. Of 44 patients evaluable for response, 28 (64%) had an objective response, including seven (16%) who had a complete response. The median duration of response was 4 months (range, 0 to 38 months), and the median survival from the time of entry was 14 months (range, less than 1 to greater than 45 months). Myelosuppression was the most common dose-limiting toxicity, with 54% of patients experiencing Grade 3 or 4 leukopenia (including 28% with granulocytopenic fever and one septic death), and cumulative Grade 3 anemia occurred in 28% of patients. Grades 3 to 4 stomatitis was observed in 18% of patients. An active, although highly toxic regimen when used as first-line therapy in MBC, M-VAC has a response rate and survival duration similar to existing, less toxic combination regimens. As such, M-VAC cannot be recommended in preference to other combination chemotherapy regimens in this clinical setting.
46例符合条件的转移性乳腺癌（MBC）患者接受了甲氨蝶呤、长春碱、阿霉素和顺铂联合方案（M-VAC）作为一线化疗。在44例可评估疗效的患者中，28例（64%）有客观反应，其中7例（16%）完全缓解。反应的中位持续时间为4个月（范围0至38个月），从入组时起的中位生存期为14个月（范围小于1至大于45个月）。骨髓抑制是最常见的剂量限制性毒性，54%的患者出现3级或4级白细胞减少（包括28%有粒细胞减少性发热和1例败血症死亡），28%的患者出现累积3级贫血。18%的患者观察到3至4级口腔炎。M-VAC作为MBC的一线治疗方案虽然毒性很大，但有活性，其缓解率和生存期与现有的毒性较小的联合方案相似。因此，在这种临床情况下，不推荐优先使用M-VAC而不是其他联合化疗方案。
