Hayes D M, Pajak T F, Rege V, Falkson G, Spurr C L, Silver R T, Nissen N I, Harley J B, Cuttner J, Glidewell O, Holland J F
Med Pediatr Oncol. 1979;6(1):23-38. doi: 10.1002/mpo.2950060105.
In 1968 the Cancer and Acute Leukemia Group B (CALGB) demonstrated optimal control of disseminated non-Hodgkin lymphomas (NHL) with vincristine-prednisone induction followed by cyclophosphamide maintenance. A study was then begun to determine whether four drugs in combination or sequence could achieve greater control. NHL patients at each participating CALGB institution were randomly assigned to one of three regimens:I) Cyclic vincristine-streptonigrin alternating every 2 weeks with cyclophosphamide-prednisone up to 155 days; II) Sequential treatment with the same 4 drugs taken singly up to 182 days; and III) Vincristine-prednisone induction for 6 weeks followed by cyclophosphamide maintenance. Results are now reported after a 10 year follow-up period. The 203 evaluable patients are those on whom Rappaport histopathologic classification was available. Frequency of complete-response did not differ significantly among the three regimens: I) 38%; II) 30%; and III) 45%. Remission durations were significantly longer among patients receiving maintenance therapy. After ten years, two patients from Regimen I, one from Regimen II, and five from Regimen III remain alive and well. It was concluded that neither of the four-drug regimens conferred a significant advantage in terms of response rate or survival time over the standard treatment.
1968年，癌症与急性白血病B组（CALGB）证明，使用长春新碱-泼尼松诱导治疗，随后进行环磷酰胺维持治疗，可实现对播散性非霍奇金淋巴瘤（NHL）的最佳控制。随后开展了一项研究，以确定四种药物联合使用或按顺序使用是否能实现更好的控制。每个参与CALGB机构的NHL患者被随机分配到三种治疗方案之一：I）长春新碱-链黑菌素每2周交替使用，同时使用环磷酰胺-泼尼松，持续155天；II）依次单独使用相同的4种药物，持续182天；III）长春新碱-泼尼松诱导治疗6周，随后进行环磷酰胺维持治疗。经过10年的随访期后，现将结果报告如下。203例可评估患者为有拉帕波特组织病理学分类的患者。三种治疗方案的完全缓解率无显著差异：I）38%；II）30%；III）45%。接受维持治疗的患者缓解期明显更长。10年后，方案I的2例患者、方案II的1例患者和方案III的5例患者仍存活且状况良好。得出的结论是，在缓解率或生存时间方面，这四种药物治疗方案均未比标准治疗具有显著优势。
