Stewart D J, Maroun J A, Laframboise G, Gerin-Lajoie J
Am J Clin Oncol. 1986 Jun;9(3):200-3. doi: 10.1097/00000421-198606000-00006.
Twenty-seven patients with squamous cell carcinoma of the head and neck were treated with i.v. cisplatin 50-100 mg/m2 followed by a rapid infusion of cytosine arabinoside 500-4,000 mg/m2. All except four of the patients had received prior irradiation and six had had prior chemotherapy. There was one early death. Of 25 evaluable patients, one (4%) achieved a complete remission and 10 (40%) achieved partial remissions lasting 6-50 weeks (median, 16 weeks). Ten patients (40%) were classified as having stable disease, including five (20%) who experienced minor responses lasting 5-8 weeks. Four patients (16%) had progressive disease. Drug doses, patient performance status, and prior exposure to chemotherapy did not appear to alter the response rate. Gastrointestinal toxicity was severe in some patients. Myelosuppression tended to be unpredictable and variable within individual patients and was not clearly related to drug doses. Two patients had generalized seizures and one became confused while hypomagnesemic. Renal toxicity, ototoxicity, and paresthesias were seen only at a cisplatin dose of 100 mg/m2. One patient developed stomatitis and one had an allergic reaction to cisplatin. There was one possible drug-related death. This regimen is reasonably well tolerated and may be somewhat more active than cisplatin alone, although further studies are needed to confirm it. Further studies involving additional doses of high dose cytosine arabinoside following cisplatin could also be worthwhile.
27例头颈部鳞状细胞癌患者接受了静脉注射顺铂，剂量为50 - 100mg/m²，随后快速输注阿糖胞苷，剂量为500 - 4000mg/m²。除4例患者外，所有患者均接受过先前的放疗，6例患者接受过先前的化疗。有1例早期死亡。在25例可评估的患者中，1例（4%）达到完全缓解，10例（40%）达到部分缓解，持续6 - 50周（中位数为16周）。10例患者（40%）被归类为病情稳定，其中5例（20%）有持续5 - 8周的轻微反应。4例患者（16%）病情进展。药物剂量、患者的体能状态以及先前接受化疗的情况似乎并未改变缓解率。一些患者出现严重的胃肠道毒性。骨髓抑制在个体患者中往往不可预测且变化不定，与药物剂量没有明显关联。2例患者出现全身性癫痫发作，1例在低镁血症时出现意识模糊。仅在顺铂剂量为100mg/m²时观察到肾毒性、耳毒性和感觉异常。1例患者发生口腔炎，1例对顺铂过敏。有1例可能与药物相关的死亡。该方案耐受性尚可，可能比单用顺铂更具活性，不过还需要进一步研究予以证实。涉及顺铂后增加高剂量阿糖胞苷的进一步研究也可能是值得的。
