Shea T C, Antman K H, Eder J P, Elias A, Peters W P, Schryber S, Henner W D, Schoenfeld D A, Schnipper L E, Frei E
Department of Medicine, Dana-Farber Cancer Institute, Boston.
Arch Dermatol. 1988 Jun;124(6):878-84. doi: 10.1001/archderm.124.6.878.
Nineteen patients with metastatic malignant melanoma were treated with 20 courses of high-dose combination alkylating agent chemotherapy and autologous bone marrow support. All 20 treatment courses were evaluable for toxic reactions and 17 of 20 courses were assessable for response. Twelve of the 20 courses were given at the phase 2 dose per square meter of cyclophosphamide (5.625 g), cisplatin (165 mg), and carmustine (600 mg). Marrow reconstitution occurred with a median time to recovery of 21 and 24 days for more than 500 neutrophils and more than 20,000 platelets, respectively. The overall response rate was 65%, with one patient achieving a complete response with chemotherapy alone. Ten additional patients achieved partial responses following chemotherapy, of which three were subsequently rendered disease free by surgical resection of single areas of residual tumor. Two of these patients are alive and disease free more than 22 months following chemotherapy and one remains relapse free. The median survival for responding patients was 15.2 months and 8.6 months for the entire group.
19例转移性恶性黑色素瘤患者接受了20个疗程的高剂量联合烷化剂化疗及自体骨髓支持治疗。所有20个治疗疗程均可评估毒性反应，20个疗程中有17个可评估疗效。20个疗程中有12个采用每平方米环磷酰胺（5.625 g）、顺铂（165 mg）和卡莫司汀（600 mg）的2期剂量给药。中性粒细胞计数超过500和血小板计数超过20,000时，骨髓重建的中位恢复时间分别为21天和24天。总体缓解率为65%，1例患者单纯化疗即达到完全缓解。另有10例患者化疗后达到部分缓解，其中3例随后通过手术切除单个残留肿瘤区域而实现无病状态。这3例患者中有2例在化疗后22个月以上仍存活且无疾病，1例仍无复发。缓解患者的中位生存期为15.2个月，整个组为8.6个月。
