Dreyfuss A I, Clark J R, Fallon B G, Posner M R, Norris C M, Miller D
Division of Medicine, Dana-Farber Cancer Institute, Boston, MA 02115.
Cancer. 1987 Dec 15;60(12):2869-72. doi: 10.1002/1097-0142(19871215)60:12<2869::aid-cncr2820601203>3.0.co;2-y.
Thirteen patients with carcinomas of major and minor salivary gland origin (nine adenoid cystic carcinomas and four adenocarcinomas) were treated with cyclophosphamide (500 mg/m2), doxorubicin (50 mg/m2), and cisplatin (50 mg/m2) (CAP) by intravenous injections on the first day of a 28-day regimen. Sixty-one cycles of CAP were administered (mean, 4.7 cycles per patient). Eleven patients were treated for palliation of recurrent disease (locoregional, ten; lung, ten; liver, three; and bone, three). Two patients untreated previously, one with extensive local disease involving the base of the skull and one with a solitary lung metastasis (resected with a positive margin) and an initially unappreciated base of tongue primary, received two cycles of CAP followed by local treatment and adjuvant CAP. Previous therapy for the 11 patients with recurrent disease included surgery (ten), radiotherapy [RT(11)], chemotherapy (three), or hormonal therapy (two). Three complete and three partial responses to chemotherapy were noted for an overall response rate of 46%. The median duration of response in palliative patients was 5 months (range, 2 to 9). Of the two patients receiving induction CAP, one relapsed with distant disease 26 months after treatment, and the other remains disease-free after 60 months of follow-up examination. Chemotherapy was well tolerated generally, and no chemotherapy-related deaths occurred. One hypertensive patient suffered a stroke after 3 cycles of therapy. CAP is an active regimen against salivary gland carcinomas and deserves further study. Also, it may be of value as induction or adjuvant treatment for patients with advanced disease untreated previously.
13例源于大、小唾液腺的癌患者（9例腺样囊性癌和4例腺癌）在28天治疗方案的第一天接受静脉注射环磷酰胺（500mg/m²）、多柔比星（50mg/m²）和顺铂（50mg/m²）（CAP方案）治疗。共进行了61个周期的CAP方案治疗（平均每位患者4.7个周期）。11例患者接受治疗以缓解复发性疾病（局部区域复发10例；肺部复发10例；肝脏复发3例；骨转移复发3例）。2例此前未接受过治疗的患者，1例患有累及颅底的广泛性局部疾病，另1例有孤立性肺转移（切除边缘阳性）且最初未发现舌根部原发性肿瘤，先接受了2个周期的CAP方案治疗，随后进行局部治疗及辅助性CAP方案治疗。11例复发性疾病患者之前接受的治疗包括手术（10例）、放疗[RT（11例）]、化疗（3例）或激素治疗（2例）。观察到3例完全缓解和3例部分缓解，总缓解率为46%。姑息治疗患者的中位缓解持续时间为5个月（范围为2至9个月）。在接受诱导性CAP方案治疗的2例患者中，1例在治疗后26个月出现远处疾病复发，另1例在随访60个月后仍无疾病。化疗总体耐受性良好，未发生与化疗相关的死亡。1例高血压患者在3个周期的治疗后发生中风。CAP方案是一种针对唾液腺癌的有效治疗方案，值得进一步研究。此外，对于此前未接受治疗的晚期疾病患者，它作为诱导或辅助治疗可能具有价值。
