Mesía R, Solá C, López Pousa A, Mendoza L, Bellet M, Andrés L, López López J J
Servicio de Oncología Médica, Hospital de la Santa Creu i Sant Pau., Barcelona.
Rev Clin Esp. 1994 Nov;194(11):960-5.
Metastatic sarcomas have a poor prognosis with current therapeutic regimens. High dose chemotherapy (HDC) has proved to be efficient in a selected group of solid tumors. Nine patients with high grade metastatic sarcomas were treated with HDC followed by autologous bone marrow transplantation. Four patients received HDC as a consolidation of the complete response (CR) obtained with chemotherapy (CT) and two of them were free from disease at 27 and 41 months, respectively. Other four patients had a disease total or partially refractory to conventional CT, and in one case the sensitivity to the chemotherapeutical agents was unknown. In these five cases a partial response was observed in two of the three who had measurable response parameters, but all of them died because of disease progression in a short period of time. These results suggest that there are active HDC schedules on metastatic sarcomas, but its possible benefit would be limited to the consolidation of a CR obtained with previous CT. HDC is a therapeutical alternative under investigation in patients with metastatic sarcomas with an indication that could be extended to cover localized sarcomas with poor prognosis.
转移性肉瘤采用当前的治疗方案预后较差。高剂量化疗(HDC)已被证明在部分实体瘤患者中有效。9例高级别转移性肉瘤患者接受了高剂量化疗,随后进行自体骨髓移植。4例患者接受高剂量化疗作为对化疗(CT)获得的完全缓解(CR)的巩固治疗,其中2例分别在27个月和41个月时无疾病进展。其他4例患者的疾病对传统CT完全或部分耐药,1例对化疗药物的敏感性未知。在这5例患者中,3例有可测量反应参数的患者中有2例观察到部分缓解,但他们均因疾病在短时间内进展而死亡。这些结果表明,存在针对转移性肉瘤的有效高剂量化疗方案,但其可能的益处仅限于巩固先前CT获得的完全缓解。高剂量化疗是正在研究的转移性肉瘤患者的一种治疗选择,其适用指征可能会扩大到预后不良的局限性肉瘤。