Evans R G, Burgert E O, Gilchrist G S, Smithson W A, Pritchard D J, Bruckman J E
Int J Radiat Oncol Biol Phys. 1984 Dec;10(12):2363-8. doi: 10.1016/0360-3016(84)90246-3.
This study was undertaken to evaluate the toxicity of sequential half-body irradiation (SHBI) and combination chemotherapy (5-FU, VM-26 and BCNU) in patients who had failed primary aggressive therapy for their Ewing's sarcoma. A secondary goal was to evaluate the response of these previously treated patients to the combination of systemic radiation and multi-agent chemotherapy. The first patient in the study was treated with SHBI only and died 139 days following retreatment. Four subsequent patients successfully received the first cycle of combination chemotherapy. However, only one completed both upper and lower half-body irradiation while the remaining three patients, because of rapid progression of their disease, completed either the upper or the lower portion of their half-body irradiation (HBI). The time from retreatment to disease progression in these four patients ranged from 45 to 97 days (mean 79 days) and the time from retreatment to death ranged from 72 to 193 days (mean 126 days). The combination chemotherapy was tolerated well by all the patients, and the SHBI was accompanied by mild nausea and some vomiting within the first few hours following treatment. Failure to give the second half of the half-body irradiation and to complete further chemotherapy in three of the patients was a result of the progressive nature of the patients' disease and not to any limitations imposed by poor blood counts. Half-body irradiation provided good pain relief within 24 hours for all of the patients. Systemic radiation contributes to the palliative treatment of patients with failed Ewing's sarcoma, but appears to be relatively ineffective when the tumor burden is high.
本研究旨在评估序贯半身照射（SHBI）及联合化疗（5-氟尿嘧啶、威猛（VM-26）和卡氮芥（BCNU））对尤因肉瘤初次积极治疗失败患者的毒性。第二个目标是评估这些先前接受过治疗的患者对全身放疗与多药联合化疗的反应。该研究的首例患者仅接受了SHBI治疗，在再次治疗后139天死亡。随后的4例患者成功接受了第一个周期的联合化疗。然而，只有1例患者完成了上半身和下半身照射，其余3例患者由于疾病进展迅速，仅完成了半身照射（HBI）的上半部分或下半部分。这4例患者从再次治疗至疾病进展的时间为45至97天（平均79天），从再次治疗至死亡的时间为72至193天（平均126天）。所有患者对联合化疗耐受性良好，SHBI在治疗后的最初几个小时内伴有轻度恶心和一些呕吐。3例患者未进行半身照射的后半程及未完成进一步化疗是由于疾病进展所致，而非血细胞计数不佳所带来的任何限制。半身照射在24小时内为所有患者提供了良好的疼痛缓解。全身放疗有助于尤因肉瘤治疗失败患者的姑息治疗，但当肿瘤负荷较高时似乎相对无效。
