Al-Ismail S A, Whittaker J A, Gough J
Department of Haematology, West Glamorgan Health Authority, Swansea, U.K.
Eur J Cancer Clin Oncol. 1987 Sep;23(9):1379-84. doi: 10.1016/0277-5379(87)90123-4.
One hundred patients with untreated non-Hodgkin's lymphoma were entered in a prospective randomized study in South and West Wales designed to assess the value of the anthracycline antibiotic, epirubicin (4'-epidoxorubicin), in their management. Patients with low grade histology and progressive disease were randomized to receive either epirubicin, vincristine and prednisolone (EVP) or cyclophosphamide, vincristine and prednisolone (CVP). The response rate of 81% in patients receiving EVP with complete remission rate of 52% were similar to a response rate of 88% and complete remission rate of 58% for patients receiving CVP. No difference was observed in survival between the two groups. Patients with high grade lymphoma were randomized to receive either cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP) or cyclophosphamide, epirubicin, vincristine and prednisolone (CEOP). The response rate was 71% for CHOP and 84% for CEOP. The complete remission rates were 46% for CHOP and 61% for CEOP. The cardiotoxicity of the two anthracyclines were monitored closely in 45 patients using measurements of systolic time intervals. Patients receiving epirubicin tolerated higher dose per course and higher total cumulative dose with less evidence of compromised left ventricular function than patients receiving doxorubicin. Epirubicin is an effective agent when used in combination chemotherapy in both low grade and high grade lymphoma with less toxicity than doxorubicin.
100例未经治疗的非霍奇金淋巴瘤患者进入了一项在南威尔士和西威尔士进行的前瞻性随机研究，该研究旨在评估蒽环类抗生素表柔比星（4'-表阿霉素）在其治疗中的价值。组织学分级低且病情进展的患者被随机分为接受表柔比星、长春新碱和泼尼松龙（EVP）或环磷酰胺、长春新碱和泼尼松龙（CVP）。接受EVP的患者缓解率为81%，完全缓解率为52%，与接受CVP的患者缓解率88%和完全缓解率58%相似。两组之间在生存率方面未观察到差异。高级别淋巴瘤患者被随机分为接受环磷酰胺、多柔比星、长春新碱和泼尼松龙（CHOP）或环磷酰胺、表柔比星、长春新碱和泼尼松龙（CEOP）。CHOP方案的缓解率为71%，CEOP方案为84%。CHOP方案的完全缓解率为46%，CEOP方案为61%。使用收缩期时间间期测量对45例患者密切监测了两种蒽环类药物的心脏毒性。与接受多柔比星的患者相比，接受表柔比星的患者每个疗程能耐受更高剂量和更高的总累积剂量，且左心室功能受损的证据更少。表柔比星在低级别和高级别淋巴瘤的联合化疗中是一种有效的药物，其毒性比多柔比星小。
