Canellos G P, Petroni G R, Barcos M, Duggan D B, Peterson B A
Division of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02115, USA.
J Clin Oncol. 1995 Aug;13(8):2005-11. doi: 10.1200/JCO.1995.13.8.2005.
To evaluate the activity and toxicity of combined etoposide, vinblastine, and doxorubicin (EVA) in advanced Hodgkin's disease (HD) in relapse from or refractory to mechlorethamine, vincristine, procarbazine, and prednisone (MOPP).
Eligible patients were more than 15 years of age and had received only one prior course of MOPP and were in relapse with measurable disease. The EVA regimen (etoposide 100 mg/m2 intravenously [IV] on days 1, 2, and 3; vinblastine 6 mg/m2 IV on day 1; and doxorubicin 50 mg/m2 IV on day 1) was administered every 28 days for a minimum of four and a maximum of six cycles. Patients were restaged at 3 and 6 months.
Forty-five eligible patients were treated, with an overall response rate of 73%. There were 40% complete responses (CRs) and 33% partial responses (PRs). The median follow-up time in 42 months. The median time to treatment failure (TTF) is 10 months, with 31% continuing progression-free. Eighteen patients achieved a second CR, with only seven recurrences in that group. Failure-free survival and overall survival were significantly better in patients whose first MOPP-induced remission was longer than 12 months and who were free of B symptoms at relapse. Toxicity was primarily myelosuppression, which resulted in two toxic deaths. Pulmonary toxicity was not observed.
EVA is an effective second-line regimen for the treatment of HD in relapse following MOPP chemotherapy.
评估依托泊苷、长春碱和多柔比星联合方案（EVA）治疗对氮芥、长春新碱、丙卡巴肼和泼尼松（MOPP）方案复发或难治的晚期霍奇金淋巴瘤（HD）的活性和毒性。
符合条件的患者年龄超过15岁，仅接受过1个疗程的MOPP方案治疗，且疾病复发且可测量。EVA方案（依托泊苷100mg/m²静脉注射[IV]，第1、2、3天；长春碱6mg/m²IV，第1天；多柔比星50mg/m²IV，第1天）每28天给药1次，最少4个周期，最多6个周期。患者在3个月和6个月时重新分期。
45例符合条件的患者接受了治疗，总缓解率为73%。完全缓解（CR）率为40%，部分缓解（PR）率为33%。中位随访时间为42个月。中位治疗失败时间（TTF）为10个月，31%的患者持续无进展。18例患者获得第二次CR，该组仅7例复发。首次MOPP诱导缓解超过12个月且复发时无B症状的患者，无失败生存和总生存显著更好。毒性主要为骨髓抑制，导致2例毒性死亡。未观察到肺部毒性。
EVA是MOPP化疗后复发的HD治疗的有效二线方案。
