Spitzer G, Dicke K A, Litam J, Verma D S, Zander A, Lanzotti V, Valdivieso M, McCredie K B, Samuels M L
Cancer. 1980 Jun 15;45(12):3075-85. doi: 10.1002/1097-0142(19800615)45:12<3075::aid-cncr2820451233>3.0.co;2-8.
In order to determine whether high-dose combination chemotherapy was active in chemotherapy resistant patients, 19 patients, (9 with small cell bronchogenic carcinoma, 6 with embryonal cell carcinoma, 2 with diffuse histiocytic lymphoma, 1 with Hodgkin's disease and 1 with chondrosarcoma), 18 of whom had had extensive prior chemotherapy and failed, received 23 courses of high-dose chemotherapy with autologous bone marrow infusion (ABMT). Three patients received four courses of cytoxan (2-6 g/m2) and VP-16 (500-600 mg/m2) and 16 patients received 19 courses of cytoxan and VP-16 in these doses plus BCNU (300 mg/m2). Activity was observed in 6 of 8 evaluable small cell bronchogenic carcinoma patients (1 complete response (CR), 4 partial responses (PR), 1 less than PR), in 6 embryonal cell carcinoma patients (3 CR, 2 PR, 1 less than PR), in both patients with diffuse histiocytic lymphoma (1 CR, 1 less than PR), in the patient with Hodgkin's disease (1 PR); and in the patient with chondrosarcoma (stable). Only 2 patients who had received prior cytoxan and VP-16 extensively showed resistance to these programs. The median response duration was 11 weeks (range = 4-55 + weeks). Major toxicity consisted of bacterial infections. Two patients died from treatment related causes. Neutrophils recovered to levels of greater than or equal to 1.5 x 10(9)/liter by days 20-42 (median, day 27) and platelets to levels of greater than 100 x 10(9)/liter by days 21-56 (median, day 32) without any delayed BCNU toxicity. High-dose combination chemotherapy with ABMT causes acceptable toxicity and high response rates of relatively short duration in tumors refractory to conventional chemotherapy.
为了确定大剂量联合化疗对化疗耐药患者是否有效，19例患者（9例小细胞支气管癌、6例胚胎性癌、2例弥漫性组织细胞淋巴瘤、1例霍奇金病和1例软骨肉瘤）接受了23个疗程的大剂量化疗并自体骨髓输注（ABMT），其中18例此前接受过广泛化疗且治疗失败。3例患者接受了4个疗程的环磷酰胺（2 - 6 g/m²）和依托泊苷（500 - 600 mg/m²），16例患者接受了19个疗程的上述剂量的环磷酰胺、依托泊苷加卡莫司汀（300 mg/m²）。在8例可评估的小细胞支气管癌患者中有6例出现疗效（1例完全缓解（CR）、4例部分缓解（PR）、1例疗效低于PR），6例胚胎性癌患者中有6例（3例CR、2例PR、1例疗效低于PR），2例弥漫性组织细胞淋巴瘤患者均出现疗效（1例CR、1例疗效低于PR），霍奇金病患者中有1例出现PR；软骨肉瘤患者病情稳定。只有2例此前广泛接受过环磷酰胺和依托泊苷治疗的患者对这些方案耐药。中位缓解持续时间为11周（范围 = 4 - 55 +周）。主要毒性反应为细菌感染。2例患者死于治疗相关原因。中性粒细胞在第20 - 42天（中位值为第27天）恢复至≥1.5×10⁹/升，血小板在第21 - 56天（中位值为第32天）恢复至＞100×10⁹/升，且未出现卡莫司汀延迟毒性反应。大剂量联合化疗及ABMT在对传统化疗难治的肿瘤中引起的毒性反应可接受，且缓解率较高但持续时间相对较短。
