Antman K H, Elias A D
Division of Medicine, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA.
Semin Surg Oncol. 1988;4(1):53-8. doi: 10.1002/ssu.2980040111.
The most active single agents in soft-tissue sarcomas are doxorubicin (Adriamycin) and ifosfamide, with response rates of 20-35%. Dacarbazine (DTIC) has a response rate of 16%. A randomized trial of 5 g/m2 of ifosfamide versus 1.5 g/m2 of cyclophosphamide noted a higher response rate for ifosfamide with less myelosuppression. Both randomized studies of doxorubicin with or without DTIC documented an increased response rate for the combination. In contrast, three randomized trials of doxorubicin-based regimens with and without cyclophosphamide have failed to detect an advantage for the addition of cyclophosphamide. Thus, the most active combination for soft-tissue sarcomas is doxorubicin and DTIC. The role of the addition of ifosfamide is currently under evaluation.
软组织肉瘤中最有效的单一药物是多柔比星（阿霉素）和异环磷酰胺，有效率为20%-35%。达卡巴嗪（DTIC）的有效率为16%。一项关于5g/m²异环磷酰胺与1.5g/m²环磷酰胺的随机试验表明，异环磷酰胺的有效率更高，骨髓抑制作用更小。两项关于多柔比星联合或不联合DTIC的随机研究均表明联合用药有效率增加。相比之下，三项关于含或不含环磷酰胺的多柔比星方案的随机试验未能发现添加环磷酰胺有优势。因此，软组织肉瘤最有效的联合用药是多柔比星和DTIC。目前正在评估添加异环磷酰胺的作用。
