Samuel L M, Harvey V J, Mitchell P L, Thompson P I, Mak D, Melville P, Evans B D
Department of Clinical Oncology, Auckland Hospital, New Zealand.
Eur J Cancer. 1994;30A(14):2054-6. doi: 10.1016/0959-8049(94)00273-8.
40 patients with symptomatic metastatic melanoma were treated with procarbazine, vincristine and lomustine (POC). 4 patients had received chemotherapy previously. Responses were seen in 8 patients (20%), 4 of whom had a complete remission. All responding patients had some tumour shrinkage after one cycle. The median duration of response was 27 weeks, with 2 patients remaining in complete remission at 6 and 6.5 years. The median survival for the whole group was 22 weeks, whilst that of the responding patients was 35 weeks. Using conventional anti-emetics, the principal toxicities were nausea and vomiting, severe in 15% of cycles. Other nonhaematological toxicity was uncommon. Neutropenia (WHO grade 3 or 4) occurred in 11% of cycles and thrombocytopenia in 8%. The response rate of metastatic melanoma to POC chemotherapy was similar to other cytotoxic regimens though toxicity, other than nausea and vomiting, was minimal. The rapid response allows patients with unresponsive disease to be identified early, avoiding continuing toxicity.
40例有症状的转移性黑色素瘤患者接受了丙卡巴肼、长春新碱和洛莫司汀（POC）治疗。4例患者此前接受过化疗。8例患者（20%）出现反应，其中4例完全缓解。所有有反应的患者在一个周期后肿瘤均有一定程度缩小。反应的中位持续时间为27周，2例患者分别在6年和6.5年时仍处于完全缓解状态。整个组的中位生存期为22周，有反应患者的中位生存期为35周。使用传统止吐药时，主要毒性为恶心和呕吐，15%的周期中症状严重。其他非血液学毒性不常见。中性粒细胞减少（世界卫生组织3级或4级）发生在11%的周期中，血小板减少发生在8%的周期中。转移性黑色素瘤对POC化疗的反应率与其他细胞毒性方案相似，不过除恶心和呕吐外，毒性极小。快速反应可使无反应疾病的患者早期得到识别，避免持续的毒性反应。
