Viens P, Maraninchi D, Legros M, Oberling F, Philip T, Herve P, Plagne R, Dufour P, Bergerat J P, Guastalla J P
Marrow Transplant Unit, Institut Paoli Calmettes, Marseille, France.
Bone Marrow Transplant. 1990 Apr;5(4):227-33.
We retrospectively evaluated the feasibility and antitumour efficacy of high dose melphalan (HDM) followed by autologous marrow rescue in 35 patients with common epithelial ovarian cancers. All patients initially had advanced disease (FIGO III-IV) and received HDM after extensive surgery and a median of 6 cycles of cis-DDP containing regimens CAP or CHAP. All, except three patients who showed evidence of progression, had a second surgical exploration before high dose chemotherapy. Melphalan was given at a dosage greater than or equal to 140 mg/m2 followed 24 h later by autologous marrow rescue. Severe but reversible aplasia and mucositis were the most common toxicities: three patients died from the procedure, two from infection and one from secondary leukaemia. HDM was effective in 75% of evaluable patients; this was evidence of activity in patients who failed to respond to first line chemotherapy. The duration of response was short, particularly for patients treated with progressive disease at the time of high dose chemotherapy rather than in partial or complete remission. With a median follow-up of 23 months (range 8-54) after high dose chemotherapy, 19 patients are alive (15 with non-progressive disease) with a projected survival of 47% between 2 and 5 years.
我们回顾性评估了35例常见上皮性卵巢癌患者接受大剂量美法仑（HDM）继以自体骨髓挽救治疗的可行性和抗肿瘤疗效。所有患者最初均为晚期疾病（国际妇产科联盟III-IV期），在广泛手术及中位6周期含顺铂方案CAP或CHAP治疗后接受HDM。除3例有疾病进展证据的患者外，所有患者在高剂量化疗前均进行了二次手术探查。美法仑剂量大于或等于140mg/m²，24小时后进行自体骨髓挽救。严重但可逆的再生障碍性贫血和粘膜炎是最常见的毒性反应：3例患者死于该治疗过程，2例死于感染，1例死于继发性白血病。HDM在75%的可评估患者中有效；这证明了其对一线化疗无效患者的活性。缓解持续时间较短，尤其是对于高剂量化疗时疾病进展而非部分或完全缓解的患者。高剂量化疗后中位随访23个月（范围8-54个月），19例患者存活（15例无疾病进展），预计2至5年生存率为47%。
