Stewart D J, Hugenholtz H, DaSilva V, Benoit B, Richard M, Russell N, Maroun J, Verma S
Semin Oncol. 1987 Jun;14(2 Suppl 1):110-5.
Twenty-five evaluable patients with gliomas were treated with a combination of cytosine arabinoside plus cisplatin administered intravenously (IV). Ten of the 25 patients (40%) responded, including three of 13 patients (23%) with prior cranial radiation, and seven of 12 patients (58%) without prior cranial radiation. In a second study, intramuscular (IM) and oral caffeine were added to IV cytosine arabinoside plus cisplatin. Caffeine-induced seizures prevented escalation of the dose of caffeine to a level that would have been anticipated to potentiate the cytotoxicity of the cytosine arabinoside plus cisplatin. Twelve of 25 treated patients (48%) responded. Most of the patients had not received prior cranial radiation. In a third study, IV cytosine arabinoside was administered in combination with intracarotid and IV cisplatin, plus BCNU and tenoposide (VM-26). This study is continuing to accrue patients. Myelosuppression has been pronounced, but has generally been rapidly reversible. It is too early to comment on efficacy of this combination. Our results to date permit us to conclude that the combination of cytosine arabinoside plus cisplatin is capable of inducing regression of gliomas in some patients. We feel that further studies are warranted.
25例可评估的胶质瘤患者接受了静脉注射阿糖胞苷和顺铂联合治疗。25例患者中有10例（40%）有反应，其中13例曾接受过颅脑放疗的患者中有3例（23%）有反应，12例未接受过颅脑放疗的患者中有7例（58%）有反应。在第二项研究中，在静脉注射阿糖胞苷和顺铂的基础上加用了肌肉注射和口服咖啡因。咖啡因诱发的癫痫发作使咖啡因剂量无法升至预期能增强阿糖胞苷和顺铂细胞毒性的水平。25例接受治疗的患者中有12例（48%）有反应。大多数患者未接受过颅脑放疗。在第三项研究中，静脉注射阿糖胞苷与颈内动脉注射和顺铂、卡莫司汀（BCNU）及替尼泊苷（VM-26）联合应用。该研究仍在招募患者。骨髓抑制明显，但一般可迅速逆转。对该联合治疗的疗效发表评论还为时过早。我们目前的结果使我们得出结论，阿糖胞苷和顺铂联合应用能够使部分胶质瘤患者的肿瘤缩小。我们认为有必要进行进一步研究。
