Mbidde E K, Selby P J, Perren T J, Dearnaley D P, Whitton A, Ashley S, Workman P, Bloom H J, McElwain T J
Section of Medicine, Institute of Cancer Research, Royal Marsden Hospital, Surrey, UK.
Br J Cancer. 1988 Dec;58(6):779-82. doi: 10.1038/bjc.1988.308.
In a series of 22 patients, high dose BCNU (800-1,000mg m-2) with autologous bone marrow transplantation was given as the first post-surgical treatment for grade IV astrocytoma and followed by full dose radiotherapy. When compared to historical experience and matched to control patients in national studies, there appeared to be a small prolongation of survival but no increase in the proportion of long survivors. Acute myelosuppression was mild but toxicity to lung and liver was substantial and limited further dose escalation. Late bone marrow failure was seen in 4 patients. Pharmacokinetic studies were performed and suggested that the late marrow failure was due to persistence of BCNU at the time of marrow return. Despite the suggestion of a prolongation of survival this approach is not routinely recommended and a randomised trial is probably not justified.
在一组22例患者中，高剂量卡氮芥（800 - 1000mg/m²）联合自体骨髓移植被用作IV级星形细胞瘤术后的首次治疗，随后进行全剂量放疗。与既往经验相比，并与全国性研究中的对照患者匹配后发现，生存期似乎有小幅延长，但长期存活者的比例并未增加。急性骨髓抑制较轻，但对肺和肝脏的毒性较大，限制了进一步的剂量递增。4例患者出现晚期骨髓衰竭。进行了药代动力学研究，结果提示晚期骨髓衰竭是由于骨髓回输时卡氮芥仍持续存在。尽管生存期有延长的迹象，但这种方法并不常规推荐，而且进行随机试验可能也不合理。
