Berkowitz R S, Goldstein D P, Bernstein M R
Gynecol Oncol. 1984 Oct;19(2):173-81. doi: 10.1016/0090-8258(84)90177-x.
Modified triple chemotherapy (MAC III: methotrexate with citrovorum factor, actinomycin D, and cyclophosphamide) was administered as primary treatment to 14 patients with high-risk metastatic gestational trophoblastic tumors (GTT). Ten (71.4%) patients attained complete remission with 1 to 4 courses of MAC III (mean = 2.7 courses). Three of the remaining patients subsequently achieved remission with the modified Bagshawe regimen or vinblastine, bleomycin, and cis-platinum. Following 38 courses of MAC III, moderate hepatotoxicity (SGOT greater than or equal to 150 U) developed after 1 (2.6%) course. Marked thrombocytopenia (platelets less than 50,000/mm3) and marked granulocytopenia (granulocytes less than 500/mm3) developed after 7 (18.4%) and 19 (50%) of the courses, respectively. Platelet transfusions were administered after 4 (10.5%) courses of MAC III and no patient required granulocyte transfusions. MAC III is an effective alternative treatment for patients with high-risk metastatic GTT.
改良三联化疗（MAC III：甲氨蝶呤联合亚叶酸钙、放线菌素D和环磷酰胺）作为初始治疗方案应用于14例高危转移性妊娠滋养细胞肿瘤（GTT）患者。10例（71.4%）患者接受1至4个疗程的MAC III治疗后达到完全缓解（平均2.7个疗程）。其余3例患者随后采用改良的巴格肖方案或长春碱、博来霉素和顺铂治疗后获得缓解。在38个疗程的MAC III治疗后，1个疗程（2.6%）后出现中度肝毒性（血清谷草转氨酶≥150 U）。分别在7个疗程（18.4%）和19个疗程（50%）后出现明显血小板减少（血小板＜50,000/mm³）和明显粒细胞减少（粒细胞＜500/mm³）。4个疗程（10.5%）的MAC III治疗后进行了血小板输注，无患者需要粒细胞输注。MAC III是高危转移性GTT患者的一种有效替代治疗方法。
