Stoll B A
Br J Cancer. 1970 Sep;24(3):475-83. doi: 10.1038/bjc.1970.57.
Dosage recommendations for cyclophosphamide therapy are examined in the light of an accumulated experience that this agent provides a useful palliation in 25% to 35% of patients with advanced breast cancer. It is concluded that an attempt to press dosage to the extreme limits of marrow tolerance does not significantly increase the likelihood of obtaining palliation, while posing a danger to the patient's life.It is also concluded that continuous low dosage schedules appear to achieve a similar incidence of tumour palliation to that from intermittent high dosage of cyclophosphamide. The latter schedule has the disadvantage of a considerably higher incidence of side effects, such as loss of scalp hair, nausea, cystitis and haemopoietic damage. Intensive dosage may however be more efficacious in the occasional case involving urgent management of a localized rapidly growing tumour. Consideration is given to other factors which may affect the degree and duration of palliation by cyclophosphamide, and to measures claimed to decrease the degree of toxicity.
根据积累的经验，对环磷酰胺治疗的剂量推荐进行了审视。该药物可使25%至35%的晚期乳腺癌患者得到有效缓解。研究得出结论，试图将剂量推至骨髓耐受的极限并不会显著增加获得缓解的可能性，反而会对患者生命构成危险。还得出结论，持续低剂量方案似乎能达到与间歇性高剂量环磷酰胺相似的肿瘤缓解发生率。后一种方案的缺点是副作用发生率高得多，如脱发、恶心、膀胱炎和造血损伤。然而，在偶尔需要紧急处理局部快速生长肿瘤的情况下，强化剂量可能更有效。文中还考虑了可能影响环磷酰胺缓解程度和持续时间的其他因素，以及声称可降低毒性程度的措施。
