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[米托蒽醌用于晚期乳腺癌的联合治疗方案]

[Mitoxantrone in a combination regimen in advanced breast cancer].

作者信息

Hausmaninger H

出版信息

Wien Med Wochenschr. 1985 Dec 31;135(23-24):594-7.

PMID:4096006
Abstract

The new anthracendione mitoxantrone, an anthraquinone derivate with structural similarities to doxorubicin (adriamycin) is active in the treatment of patients with metastatic breast cancer. It has less acute toxicity than doxorubicin, may be non cross resistant with doxorubicin and appears to have less cardiotoxicity. Phase-II-studies have confirmed antitumor activity ranging from 6 to 36%, mitoxantrone combined with conventional drugs produced response rates between 25 and 90%. 32 heavily pretreated patients--nearly 70% had visceral metastasis--were assigned to treatment with vindesine 3 mg/m2 i.v. and mitoxantrone 10 to 12 mg/m2 by i.v. infusion. Treatment cycles initially were repeated every 3 weeks. 25/32 patients are available for response. There were 1 complete remission (4%), 3 partial remissions (12%), 2 minor responses (8%) (remissions + minor responses = 24%), 7 no change (28%) and 12 failures (48%). Response durations were 11, 8, +5, +6 months. The acute toxicity was mild, nausea or vomiting grade greater than or equal to 2 were found only in 4/32 patients (12%), the rate of alopecia grade greater than or equal to 2 was 28% (only 2 patients [6%] required a wig). Myelosuppression on the other hand was moderate. Nearly two thirds of patients developed leucopenia less than 2,0 X 10(9)/I, in 22% of patients platelet nadir less than 100,0 X 10(9)/I was registered. In conclusion these preliminary results suggest an improvement in therapeutic index with this treatment regimen.

摘要

新型蒽二酮米托蒽醌是一种蒽醌衍生物,其结构与阿霉素(多柔比星)相似,在转移性乳腺癌患者的治疗中具有活性。它的急性毒性比阿霉素小,可能与阿霉素无交叉耐药性,且心脏毒性似乎较小。Ⅱ期研究已证实其抗肿瘤活性在6%至36%之间,米托蒽醌与传统药物联合使用的缓解率在25%至90%之间。32例经过大量预处理的患者(近70%有内脏转移)被分配接受长春地辛3mg/m²静脉注射和米托蒽醌10至12mg/m²静脉输注治疗。治疗周期最初每3周重复一次。25/32例患者可供评估疗效。有1例完全缓解(4%),3例部分缓解(12%),2例轻度缓解(8%)(缓解+轻度缓解=24%),7例病情无变化(28%),12例治疗失败(48%)。缓解持续时间分别为11个月、8个月、+5个月、+6个月。急性毒性较轻,仅4/32例患者(12%)出现≥2级恶心或呕吐,≥2级脱发率为28%(仅2例患者[6%]需要假发)。另一方面,骨髓抑制为中度。近三分之二的患者出现白细胞减少至<2.0×10⁹/L,22%的患者血小板最低点<100.0×10⁹/L。总之,这些初步结果表明该治疗方案的治疗指数有所提高。

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