Kohda K, Tsuji A, Takayanagi N, Takeda M, Hayashi S, Takimoto R, Fujisaki Y, Tsuji Y, Ezoe A, Nakazawa O
Dept. of Internal Medicine, Japanese Red Cross Asahikawa Hospital.
Gan To Kagaku Ryoho. 1993 Nov;20(14):2183-9.
We conducted a new chemotherapy, NEO-MAC OP-B (addition of etoposide and mitoxantrone to MACOP-B with half dose of methotrexate and half administration of doxorubicin), to reduce severe mucositis, which is a major toxic effect of MACOP-B, and to increase its effect with etoposide and mitoxantrone as new non-cross resistant drugs. Between Jan. 1989 and Mar. 1993, 12 patients with previously untreated advanced aggressive non-Hodgkin's lymphoma (NHL), 2 patients with adult T cell lymphoma, and 3 patients with relapsed NHL, were treated with NEO-MACOP-B. After termination of NEO-MACOP-B therapy, 83.3% of 12 patients with previously untreated NHL were in complete remission (CR). After median follow-up of 22 months, Kaplan-Meier estimates showed that overall survival of 12 previously untreated patients was 71.4%, and relapse-free survival of complete responder was 83.3%. Toxic effects on all 17 patients were moderate with a lower incidence of severe mucositis (only one patient with relatively severe stomatitis, WHO Grade 3). No treatment related deaths were observed. Thus, NEO-MACOP-B is an effective and safe treatment for advanced stage aggressive NHL.
我们开展了一种新的化疗方案，即NEO-MAC OP-B（在MACOP-B方案基础上加用依托泊苷和米托蒽醌，同时将甲氨蝶呤剂量减半、阿霉素给药次数减半），以减轻MACOP-B的主要毒副作用——严重黏膜炎，并通过使用依托泊苷和米托蒽醌这两种新的非交叉耐药药物来增强其疗效。1989年1月至1993年3月期间，12例先前未经治疗的晚期侵袭性非霍奇金淋巴瘤（NHL）患者、2例成人T细胞淋巴瘤患者以及3例复发的NHL患者接受了NEO-MAC OP-B方案治疗。在NEO-MAC OP-B治疗结束后，12例先前未经治疗的NHL患者中有83.3%达到完全缓解（CR）。经过中位22个月的随访，Kaplan-Meier估计显示，12例先前未经治疗患者的总生存率为71.4%，完全缓解者的无复发生存率为83.3%。所有17例患者的毒副作用均为中度，严重黏膜炎的发生率较低（仅有1例患者出现相对严重的口腔炎，世界卫生组织3级）。未观察到与治疗相关的死亡病例。因此，NEO-MAC OP-B是晚期侵袭性NHL的一种有效且安全的治疗方法。
