Kurucu Nilgun, Sari Neriman, Ilhan Inci Ergurhan
Department of Pediatric Oncology, Institute of Cancer, Hacettepe University , Ankara , Turkey.
Pediatr Hematol Oncol. 2015 Feb;32(1):50-9. doi: 10.3109/08880018.2014.954070. Epub 2014 Sep 24.
Long-term survival in relapsed Ewing sarcoma (ES) is less than 20%. Encouraging results have been reported with irinotecan and temozolomide combinations (IRN/TMZ). We aimed to share our experience and compare it with previously published studies using this combination to treat relapsed ES. We retrospectively evaluated 20 patients treated with a combination of IRN (20 mg/m(2)/d × 5 for 2 weeks) and temozolomide (100 mg/m(2)/d × 5). Patients received a total of 97 courses. An objective response was achieved in 11 patients (55%) and maintained for a median of 12 months. Five patients were alive for a median of 12 months. Median time to progression was 5.5 (2-57) months. After the IRN/TMZ treatment, 1-year overall and event-free survival rates were 54.2% and 44.4%, respectively. Grade 3-4 toxicities included diarrhea (9.2%), neutropenia (11.3%), and thrombocytopenia (6.2%). Three retrospective trials were found in our literature review, which used an IRN/TMZ combination to treat ES. There was one other study which retrospectively evaluated the efficacy of vincristine, IRN, and TMZ combination in relapsed ES. A total of 81 patients were treated with IRN/TMZ in four studies including ours. The objective response rate was 55.1%, and median time to progression ranged from 5.5 to 8.3 months. Twenty-six (7.5%) of a total of 346 courses were associated with grade 3-4 diarrhea. Grade 3-4 neutropenia and thrombocytopenia were reported in 9.2% and 7.2% of the courses, respectively. Results showed that an IRN/TMZ combination is effective and tolerable in patients with relapsed ES.
复发性尤因肉瘤（ES）的长期生存率低于20%。已有报道显示伊立替康和替莫唑胺联合用药（IRN/TMZ）取得了令人鼓舞的结果。我们旨在分享我们的经验，并将其与此前发表的使用该联合方案治疗复发性ES的研究进行比较。我们回顾性评估了20例接受IRN（20mg/m²/d×5，共2周）和替莫唑胺（100mg/m²/d×5）联合治疗的患者。患者共接受了97个疗程的治疗。11例患者（55%）获得客观缓解，缓解持续时间的中位数为12个月。5例患者存活，存活时间的中位数为12个月。疾病进展时间的中位数为5.5（2 - 57）个月。IRN/TMZ治疗后，1年总生存率和无事件生存率分别为54.2%和44.4%。3 - 4级毒性反应包括腹泻（9.2%）、中性粒细胞减少（11.3%）和血小板减少（6.2%）。在我们的文献综述中发现了三项回顾性试验，它们使用IRN/TMZ联合方案治疗ES。还有一项研究回顾性评估了长春新碱、IRN和TMZ联合方案治疗复发性ES的疗效。包括我们的研究在内的四项研究中，共有81例患者接受了IRN/TMZ治疗。客观缓解率为55.1%，疾病进展时间的中位数为5.5至8.3个月。在总共346个疗程中，有26个（7.5%）与3 - 4级腹泻相关。3 - 4级中性粒细胞减少和血小板减少分别在9.2%和7.2%的疗程中出现。结果表明，IRN/TMZ联合方案对复发性ES患者有效且耐受性良好。
