Riccardi A, Merlini G, Montecucco C, Danova M, Ucci G, Cassano E, Ascari E
Eur J Cancer Clin Oncol. 1986 Jul;22(7):787-91. doi: 10.1016/0277-5379(86)90364-0.
Seventy-five patients with previously untreated multiple myeloma were randomly treated with the association of Peptichemio, Vincristine and prednisone (PTC-VCR-P) or of melphalan and P (MPH-P) for first induction therapy. After induction, all responsive patients received MPH and P until relapse, while unresponsive patients received it until unequivocal evidence of disease progression was observed. A second induction therapy with PTC-VCR-P was then administered, except to patients resistant to this association at first induction (who received combination chemotherapy which included cyclophosphamide and adriamycin). The response rate was 58% in the PTC-VCR-P and 41% in the MPH-P group (P greater than 0.05). The PTC-VCR-P responsive patients experienced a median duration of response shorter than MPH-P responsive patients (20.3 vs 39.7, P = 0.041). Median survival from the start of treatment was 26.2 months in the PTC-VCR-P and 54.1 months in the MPH-P group of patients (P = 0.039). Stage I and II myelomas had the same response rate to PTC-VCR-P and to MPH-P, but their survival was shorter on PTC-VCR-P than on MPH-P (P = 0.014). Stage III myelomas responded more frequently to PTC-VCR-P than to MPH-P (P less than 0.02) and there was a trend to survive longer on PTC-VCR-P than on MPH-P (22.0 vs 12.5 months, P greater than 0.05).
75例既往未接受过治疗的多发性骨髓瘤患者被随机分为两组，分别接受胃酶抑素、长春新碱和泼尼松联合方案（PTC-VCR-P）或马法兰与泼尼松联合方案（MPH-P）进行首次诱导治疗。诱导治疗后，所有有反应的患者接受MPH和P直至复发，而无反应的患者则持续接受该治疗，直至观察到明确的疾病进展证据。然后对患者进行第二次诱导治疗，使用PTC-VCR-P，但首次诱导时对该联合方案耐药的患者除外（这些患者接受包含环磷酰胺和阿霉素的联合化疗）。PTC-VCR-P组的缓解率为58%，MPH-P组为41%（P>0.05）。PTC-VCR-P有反应的患者的中位缓解持续时间短于MPH-P有反应的患者（20.3对39.7，P=0.041）。从治疗开始计算，PTC-VCR-P组患者的中位生存期为26.2个月，MPH-P组为54.1个月（P=0.039）。I期和II期骨髓瘤对PTC-VCR-P和MPH-P的缓解率相同，但接受PTC-VCR-P治疗时的生存期短于MPH-P治疗（P=0.014）。III期骨髓瘤对PTC-VCR-P的反应比MPH-P更频繁（P<0.02），并且有接受PTC-VCR-P治疗的生存期长于MPH-P治疗的趋势（22.0对12.5个月，P>0.05）。
