Wheeler R H, Liepman M K, Baker S R, Earhart R H, Bull F E, Ensminger W D
Cancer Treat Rep. 1980 Aug-Sep;64(8-9):943-9.
Forty-two patients with metastatic squamous cell carcinoma were treated with bleomycin, vincristine, and mitomycin C with or without methotrexate (BOM +/- M). The overall response rate of 64% (complete response [CR] rate, 19%) included 19 responses among 26 patients (seven CRs) with head and neck cancer, three responses among eight patients with cervical cancer, and three responses among five patients (one CR) with lung cancer. Six of 12 patients (two CRs) responded to BOM and 21 of 30 patients (six CRs) responded to BOMM. The median duration of response was 16 weeks. Toxic effects included nausea or vomiting in 33% of the patients, fever of > 101 degrees C in 26%, stomatitis in 29% and pulmonary toxicity in 19%. Four of eight cases of pulmonary toxicity were fatal and the incidence was related to the amount of both bleomycin and mitomycin C administered. The occurrence of pulmonary toxicity could not be predicted by serial determination of pulmonary function or blood gases. A wbc count nadir of < 2500/mm3 occurred in 15 of 42 patients. There were two episodes of sepsis with one death. A platelet count nadir of > 75,000/mm3 occurred in eight of 42 patients with no episodes of hemorrhage. BOMM produces a high objective response rate in patients with squamous cell cancer. However, the duration of remission is brief, and use of the regimen carries an increased risk of fatal pulmonary toxicity.
42例转移性鳞状细胞癌患者接受了博来霉素、长春新碱和丝裂霉素C治疗，部分患者加用或未加用甲氨蝶呤（BOM +/- M方案）。总缓解率为64%（完全缓解[CR]率为19%），其中26例头颈部癌患者中有19例缓解（7例CR），8例宫颈癌患者中有3例缓解，5例肺癌患者中有3例缓解（1例CR）。12例患者中有6例（2例CR）对BOM方案有反应，30例患者中有21例（6例CR）对BOMM方案有反应。缓解的中位持续时间为16周。毒性反应包括33%的患者出现恶心或呕吐，26%的患者体温高于101华氏度，29%的患者出现口腔炎，19%的患者出现肺部毒性。8例肺部毒性病例中有4例死亡，其发生率与博来霉素和丝裂霉素C的给药量有关。通过连续测定肺功能或血气无法预测肺部毒性的发生。42例患者中有15例白细胞计数最低点低于2500/mm3。发生了2次败血症，1例死亡。42例患者中有8例血小板计数最低点高于75,000/mm3，未发生出血事件。BOMM方案在鳞状细胞癌患者中产生了较高的客观缓解率。然而，缓解期较短，且使用该方案会增加致命肺部毒性的风险。
