Rustin G J, Newlands E S, Begent R H, Dent J, Bagshawe K D
Department of Medical Oncology, Charing Cross Hospital, London, UK.
J Clin Oncol. 1989 Jul;7(7):900-3. doi: 10.1200/JCO.1989.7.7.900.
Twenty-five patients with CNS metastases of choriocarcinoma were treated with a regimen incorporating etoposide, methotrexate, and actinomycin (EMA) alternating weekly with vincristine and cyclophosphamide (CO). The dose of methotrexate was increased to 1 g/m2. Eighteen patients presented with CNS metastases, or developed them on inappropriate treatment started elsewhere. Following EMA/CO chemotherapy, three patients died within the first 3 weeks, one is alive with active disease, one died with drug resistance, and 13 (72%) patients are surviving disease-free. Two of seven patients (29%) who developed CNS metastases on treatment with EMA/CO or relapsed after EMA/CO are disease-free after additional chemotherapy and surgery. The contribution toward survival of the craniotomy in six of 18 patients treated initially or early with EMA/CO remains unclear, but was crucial to those patients with drug resistance.
25例绒毛膜癌中枢神经系统转移患者接受了一种治疗方案，该方案包括依托泊苷、甲氨蝶呤和放线菌素（EMA），每周与长春新碱和环磷酰胺（CO）交替使用。甲氨蝶呤的剂量增加到1 g/m²。18例患者出现中枢神经系统转移，或在其他地方开始的不适当治疗过程中发生了转移。在EMA/CO化疗后，3例患者在最初3周内死亡，1例患者存活但疾病仍处于活动期，1例患者因耐药死亡，13例（72%）患者无病存活。在接受EMA/CO治疗时发生中枢神经系统转移或在EMA/CO治疗后复发的7例患者中，有2例（29%）在接受额外化疗和手术后无病生存。在最初或早期接受EMA/CO治疗的18例患者中，有6例接受了开颅手术，其对生存的贡献尚不清楚，但对那些耐药患者至关重要。
