Loehrer P J, Kim K, Aisner S C, Livingston R, Einhorn L H, Johnson D, Blum R
Department of Medicine, Indiana University Medical Center, Indianapolis 46202.
J Clin Oncol. 1994 Jun;12(6):1164-8. doi: 10.1200/JCO.1994.12.6.1164.
The purpose of this study was to evaluate the impact of cisplatin, doxorubicin, and cyclophosphamide (PAC) in patients with advanced thymoma with respect to response rate, duration of remission, and overall survival.
Assessable patients with thymoma (n = 29) or thymic carcinoma (n = 1) with metastatic or locally progressive recurrent disease following radiotherapy were treated with intravenous cisplatin (50 mg/m2), doxorubicin (50 mg/m2), and cyclophosphamide (500 mg/m2) with normal saline hydration. Courses were repeated every 3 weeks for a maximum of eight cycles of therapy.
Toxicity, which was primarily hematologic, was mild, with only one patient developing a fever associated with neutropenia. Three complete responses (CRs) and 12 partial responses (PRs) were observed (CR+PR rate, 50%; 95% confidence interval, 31.3% to 68.7%). Ten patients had stable disease. The median duration of response was 11.8 months (range, 0.9 to 70.5+), the time to treatment failure 18.4 months (range, 0.8 to 91.9+), and median survival time 37.7 months (range, 2 to 91.9+).
This trial demonstrates that objective response rates and prolonged survival can be achieved in patients with advanced thymoma.
本研究旨在评估顺铂、阿霉素和环磷酰胺（PAC）对晚期胸腺瘤患者的缓解率、缓解持续时间和总生存期的影响。
可评估的胸腺瘤患者（n = 29）或胸腺癌患者（n = 1），在放疗后出现转移性或局部进展性复发性疾病，接受静脉注射顺铂（50 mg/m²）、阿霉素（50 mg/m²）和环磷酰胺（500 mg/m²）治疗，并以生理盐水水化。每3周重复疗程，最多进行8个周期的治疗。
毒性反应主要为血液学毒性，程度较轻，仅有1例患者出现与中性粒细胞减少相关的发热。观察到3例完全缓解（CR）和12例部分缓解（PR）（CR + PR率为50%；95%置信区间为31.3%至68.7%）。10例患者病情稳定。中位缓解持续时间为11.8个月（范围为0.9至70.5+），治疗失败时间为18.4个月（范围为0.8至91.9+），中位生存时间为37.7个月（范围为2至91.9+）。
本试验表明，晚期胸腺瘤患者可实现客观缓解率并延长生存期。
