Crist W M, Raney R B, Ragab A, Heyn R, Wharam M, Webber B, Johnston J, Beltangady M
Med Pediatr Oncol. 1987;15(2):51-7. doi: 10.1002/mpo.2950150202.
Forty-two children, 6 months to 17 years of age with newly diagnosed soft-tissue sarcomas (gross residual or metastatic), were treated according to either of two pilot protocols that included intensive chemotherapy before irradiation. Vincristine, actinomycin D, cyclophosphamide, and doxorubicin were used in various combinations with cisplatin alone (regimen 35) or with cisplatin plus etoposide (regimen 36) in a 20-week induction treatment; irradiation (4,000 cGy) was delayed until week 6. Fourteen (82%) of the 17 patients on regimen 35 and 15 (60%) of the 25 on regimen 36 had a complete response. Although severe leukopenia was frequent in both groups (88% and 84% of patients), there were only two fatal infections and no early deaths. Other potentially serious toxicity included a greater than 10% weight loss in 52% of the patients and hypomagnesemia in 74%. An average of 75-100% of the prescribed drug doses were administered during the induction phase of therapy. We conclude that this intensified treatment is toxic but feasible to deliver. The higher overall response rate compared to that in the preceding Intergroup Rhabdomyosarcoma Study (69% vs 53%) suggests improved therapeutic efficacy that warrants further evaluation of both regimens.
42例6个月至17岁新诊断为软组织肉瘤（肉眼残留或转移）的儿童，按照两种试验方案之一进行治疗，这两种方案均包括放疗前的强化化疗。在为期20周的诱导治疗中，长春新碱、放线菌素D、环磷酰胺和阿霉素与单独使用顺铂（方案35）或顺铂加依托泊苷（方案36）以不同组合使用；放疗（4000 cGy）推迟至第6周。方案35的17例患者中有14例（82%）、方案36的25例患者中有15例（60%）获得完全缓解。虽然两组严重白细胞减少症都很常见（分别为88%和84%的患者），但仅有2例致命感染，无早期死亡。其他潜在的严重毒性包括52%的患者体重减轻超过10%以及74%的患者出现低镁血症。在治疗诱导期平均给予了75 - 100%的规定药物剂量。我们得出结论，这种强化治疗有毒性但可行。与之前的横纹肌肉瘤协作组研究相比，总体缓解率更高（69%对53%），提示治疗效果有所改善，这两种方案均值得进一步评估。
