Long H J, Langdon R M, Cha S S, Veeder M H, Pfeifle D M, Krook J E, Ebbert L P, Tschetter L K, Roshon S G
Mayo Clinic, Rochester, Minnesota 55905, USA.
Gynecol Oncol. 1995 Aug;58(2):240-3. doi: 10.1006/gyno.1995.1217.
A phase II combination chemotherapy protocol combining methotrexate, vinblastine, doxorubicin, and cisplatin was designed to evaluate tumor response and survival in patients with advanced/recurrent endometrial carcinoma. Thirty patients with advanced/recurrent endometrial carcinoma were assigned to chemotherapy treatment at 4-week intervals with methotrexate 30 mg/m2 i.v. Days 1, 15, and 22; vinblastine 3 mg/m2 i.v. Days 2, 15, and 22; doxorubicin 30 mg/m2 i.v. Day 2; and cisplatin 70 mg/m2 i.v. Day 2. After a median of four cycles (maximum number two cycles beyond complete regression; minimum six cycles for stable partial regression), we observed objective regression in 20 patients (67%) (95% CI, 50, 84) with complete regression in 8 patients (27%) and partial regression in 12 patients (40%). Median overall survival was 9.9 months (range, 0.3-34.2), and median survival of responders was 11.0 months (range, 2.6-34.2) from initial date of response. Toxicity was substantial with two treatment-related deaths and consisted predominantly of neutropenia (grade 3 or greater in 93% of the patients), alopecia, nausea, emesis, stomatitis, and azotemia. In conclusion, MVAC is a highly active outpatient chemotherapy regimen in patients with advanced/recurrent endometrial carcinoma, achieving a high complete and partial response rate. Toxicity is substantial in this elderly patient population.
设计了一种将甲氨蝶呤、长春碱、阿霉素和顺铂联合使用的II期联合化疗方案，以评估晚期/复发性子宫内膜癌患者的肿瘤反应和生存率。30例晚期/复发性子宫内膜癌患者接受化疗，每4周进行一次，具体用药为：甲氨蝶呤30mg/m²，静脉注射，第1、15和22天；长春碱3mg/m²，静脉注射，第2、15和22天；阿霉素30mg/m²，静脉注射，第2天；顺铂70mg/m²，静脉注射，第2天。经过中位4个周期（完全缓解后最多2个周期；稳定部分缓解最少6个周期）的治疗后，我们观察到20例患者（67%）（95%CI，50, 84）出现客观缓解，其中8例患者（27%）完全缓解，12例患者（40%）部分缓解。从初始缓解日期起，中位总生存期为9.9个月（范围，0.3 - 34.2），缓解者的中位生存期为11.0个月（范围，2.6 - 34.2）。毒性反应严重，有2例与治疗相关的死亡，主要毒性反应包括中性粒细胞减少（93%的患者为3级或更高）、脱发、恶心、呕吐、口腔炎和氮质血症。总之，MVAC方案是晚期/复发性子宫内膜癌患者一种高效的门诊化疗方案，完全缓解率和部分缓解率都很高。在这个老年患者群体中，毒性反应严重。
