Jackson D V, Craig J B, Spurr C L, White D R, Muss H B, Cruz J M, Richards F, Powell B L
Piedmont Oncology Association and Cancer Center, Wake Forest University, Winston-Salem, North Carolina 27103.
Cancer Invest. 1990;8(1):7-12. doi: 10.3109/07357909009017541.
Phase I and II trials of vincristine infusion have demonstrated the safety and efficacy of this approach in the treatment of patients with refractory non-Hodgkin's lymphoma. Subsequently, a trial was designed to evaluate this technique in untreated patients. Repeated 5-day infusions of vincristine 0.25 mg/m2 per day were incorporated into a CHOP-CCNU regimen and administered to 24 patients with advanced diffuse large-cell lymphoma. Objective responses occurred rapidly and were observed in 18 (75%) patients in whom 13 (54%) were complete. Toxicity was generally mild to moderate and neurotoxicity appeared to be no worse than typically observed with bolus vincristine. Complete responses have been durable in most patients and 10 (77%) of the complete responders have not relapsed. At this time, 9 (38%) of the total patients remain alive and without evidence of disease from 3.8 to 7.3 years from the start of treatment. One patient died of disseminated gastric cancer at 3.3 years from the start of therapy and there was no evidence of lymphoma at exploratory laparotomy. Infusion of vincristine may be safely incorporated into multiagent chemotherapy programs of the CHOP type for non-Hodgkin's lymphoma. Its potential for protracted nonmyelosuppressive cell kill would appear attractive in designing future trials for this disease.
长春新碱静脉输注的I期和II期试验已证明该方法在治疗难治性非霍奇金淋巴瘤患者中的安全性和有效性。随后，设计了一项试验来评估该技术在未经治疗的患者中的效果。将长春新碱0.25mg/m²每天重复5天的静脉输注纳入CHOP-CCNU方案，并给予24例晚期弥漫性大细胞淋巴瘤患者。客观缓解迅速出现，18例（75%）患者出现缓解，其中13例（54%）完全缓解。毒性一般为轻度至中度，神经毒性似乎并不比静脉推注长春新碱时通常观察到的更严重。大多数患者的完全缓解持续存在，10例（77%）完全缓解者未复发。此时，从治疗开始起3.8至7.3年，9例（38%）患者仍存活且无疾病证据。1例患者在治疗开始3.3年后死于播散性胃癌，剖腹探查时无淋巴瘤证据。长春新碱静脉输注可安全地纳入CHOP方案的多药化疗中用于非霍奇金淋巴瘤。在设计该疾病的未来试验中，其延长非骨髓抑制性细胞杀伤的潜力似乎很有吸引力。
