Pendleton N, Green J A
Mersey Regional Centre for Radiotherapy and Oncology, Clatterbridge Hospital, Bebington, U.K.
Acta Oncol. 1994;33(5):513-8. doi: 10.3109/02841869409083927.
Forty-eight patients with intermediate and high-grade NHL were treated with an intensive weekly six-drug regimen of methotrexate, doxorubicin, prednisolone, etoposide, cyclophosphamide and vincristine (MAPECO) between 1982-1988 and now have a median follow-up of 4.8 years. Nineteen of these patients received an intensified derivative of this regimen with the incorporation of bleomycin. Histological sub-type showed intermediate grade in 28 and high grade in 20 patients. Forty-five patients received the 4 planned cycles, and all patients achieved an objective response, of whom 36 (75%) entered complete remission. At 5 years, the actuarial survival of the 48 patients was 50%. Of the 36 patients achieving complete remission, the relapse-free survival at 5 years was 62%. The 5-year time to treatment failure was 48% for the whole group and 40% for the 22 stage III+IV patients. Histological sub-type had no effect on survival and time to failure curves. Neutropenic fever occurred in 15 patients and grade 3/4 mucositis was seen in 25. The MAPECO combination is an effective intensive regimen with acceptable toxicity for intermediate and high-grade lymphoma.
1982年至1988年间，48例中高度非霍奇金淋巴瘤（NHL）患者接受了甲氨蝶呤、阿霉素、泼尼松龙、依托泊苷、环磷酰胺和长春新碱的强化每周六药方案（MAPECO）治疗，目前中位随访时间为4.8年。其中19例患者接受了加入博来霉素的该方案强化衍生方案。组织学亚型显示，28例为中等级别，20例为高等级别。45例患者接受了4个计划周期的治疗，所有患者均获得客观缓解，其中36例（75%）进入完全缓解。5年时，48例患者的精算生存率为50%。在36例获得完全缓解的患者中，5年无复发生存率为62%。整个组的5年治疗失败时间为48%，22例III+IV期患者为40%。组织学亚型对生存曲线和治疗失败时间曲线无影响。15例患者发生中性粒细胞减少性发热，25例出现3/4级粘膜炎。MAPECO联合方案是一种有效的强化方案，对中高度淋巴瘤具有可接受的毒性。
