Bruckner H W, Cohen C J, Feuer E, Holland J F
Department of Neoplastic Diseases, Cancer Center of Mount Sinai, New York, New York.
Obstet Gynecol. 1989 Mar;73(3 Pt 1):349-56.
For 61 patients with stage III-IV carcinoma of the ovary, chemotherapy consisted first of cisplatin 50 mg/m2 on day 1, cyclophosphamide 500 mg/m2 on day 3, doxorubicin 50 mg/m2 on day 3, and hexamethylmelamine 100 mg/m2 on days 4-15 every 4 weeks. The dosages of doxorubicin and hexamethylmelamine were increased by 60 and 100%, respectively, until the nadir white blood cell counts fell to 1.0 x 10(9)/L. This regimen was less neurotoxic and nephrotoxic than other intensive treatments and produced better therapeutic effects than did the immediate preceding Mount Sinai regimens: 1) The overall median survival was 43 months and progression-free survival was 25 months; 2) the greatest benefit occurred among patients under 50 years of age; 3) regression of large tumors increased in frequency, with 33% of tumors 2-6 cm and 16% of tumors larger than 6 cm converted to either pathologically proved remission or microscopic disease; and 4) for the first time, partial surgical debulking producing residual tumors less than 6 cm in size improved early survival.
对于61例III - IV期卵巢癌患者，化疗方案如下：第1天给予顺铂50 mg/m²，第3天给予环磷酰胺500 mg/m²、阿霉素50 mg/m²，每4周的第4 - 15天给予六甲蜜胺100 mg/m²。阿霉素和六甲蜜胺的剂量分别增加60%和100%，直至白细胞计数最低点降至1.0×10⁹/L。该方案的神经毒性和肾毒性低于其他强化治疗方案，且治疗效果优于此前的西奈山治疗方案：1) 总体中位生存期为43个月，无进展生存期为25个月；2) 最大获益出现在50岁以下患者中；3) 大肿瘤缩小的频率增加，2 - 6 cm的肿瘤中有33%、大于6 cm的肿瘤中有16%转变为病理证实的缓解或微小病变；4) 首次发现，部分手术减瘤使残留肿瘤小于6 cm可改善早期生存率。
