Phillips G L, Wolff S N, Fay J W, Herzig R H, Lazarus H M, Schold C, Herzig G P
J Clin Oncol. 1986 May;4(5):639-45. doi: 10.1200/JCO.1986.4.5.639.
Intensive monochemotherapy with carmustine (BCNU) (either 1,050, 1,200, or 1,350 mg/m2) and cryopreserved autologous marrow transplantation was administered to 36 patients with malignant glioma: 27 with progressive disease and nine without progression (adjuvant therapy group). Twelve (44%) of the patients with progressive disease responded; two remain disease free 84 and 60 months after BCNU treatment. In the adjuvant therapy group, three patients remain progression free at 70, 48, and 27 months after BCNU therapy. Tumor progression posttransplantation occurred in 25 patients; six others died of therapy-induced complications. In addition, late neurologic deterioration of unknown cause has developed in two surviving patients. Results from this and other series using intensive BCNU monochemotherapy and autologous marrow transplantation for progressive malignant glioma indicate that prolonged progression-free survival can be produced in an occasional patient, an extremely unusual result with conventional chemotherapy. Although intensive BCNU and autologous marrow transplant regimens are toxic, these results are encouraging. The treatment of patients in an adjuvant fashion with BCNU and other active agents may produce improved results.
对36例恶性胶质瘤患者进行了卡莫司汀（BCNU）强化单一化疗（剂量分别为1050、1200或1350mg/m²）并联合冷冻保存的自体骨髓移植：27例为疾病进展期患者，9例为无疾病进展患者（辅助治疗组）。疾病进展期患者中有12例（44%）有反应；2例在BCNU治疗后84个月和60个月仍无疾病。在辅助治疗组中，3例患者在BCNU治疗后70、48和27个月仍无疾病进展。25例患者移植后出现肿瘤进展；另外6例死于治疗引起的并发症。此外，2例存活患者出现了原因不明的晚期神经功能恶化。该研究以及其他使用BCNU强化单一化疗和自体骨髓移植治疗进展期恶性胶质瘤的系列研究结果表明，偶尔有患者可实现延长的无进展生存期，这是传统化疗极不常见的结果。尽管BCNU强化治疗和自体骨髓移植方案有毒性，但这些结果令人鼓舞。采用BCNU和其他活性药物对患者进行辅助治疗可能会取得更好的效果。
