Douglass E C, Reynolds M, Finegold M, Cantor A B, Glicksman A
Department of Hematology/Oncology, St Jude Children's Research Hospital, Memphis, TN.
J Clin Oncol. 1993 Jan;11(1):96-9. doi: 10.1200/JCO.1993.11.1.96.
To estimate the disease-free survival rate in children with grossly resected hepatoblastoma treated with cisplatin, vincristine, and fluorouracil (CDDP/VCR/FU) and to assess the disease-response rate and disease-free survival (DFS) rate in children with unresectable or metastatic tumors treated with this combination.
Sixty assessable patients with hepatoblastoma received therapy with five (stage I and II) to seven (stage III and IV) courses of CDDP (90 mg/m2), day 1, and VCR (1.5 mg/m2), and FU (600 mg/m2), day 3.
Nineteen of 21 patients with stage I or II disease survive free of disease (actuarial survival, 90% at 5 years). Twenty-four of 31 patients with stage III disease achieved a complete remission (CR) after chemotherapy and surgical excision; actuarial DFS at 4 years is 67%. Only one of eight patients with stage IV disease achieved a remission and survives.
Relatively brief exposure to chemotherapy with CDDP/VCR/FU provided excellent disease control to patients with grossly resected tumors. In patients with initially unresectable disease, this therapy provides a response rate and DFS rate comparable to regimens that contain doxorubicin (DOX).
评估接受顺铂、长春新碱和氟尿嘧啶（CDDP/VCR/FU）治疗的肝母细胞瘤全切患儿的无病生存率，并评估接受该联合治疗的不可切除或转移性肿瘤患儿的疾病缓解率和无病生存率（DFS）。
60例可评估的肝母细胞瘤患者接受了5（Ⅰ期和Ⅱ期）至7（Ⅲ期和Ⅳ期）个疗程的治疗，顺铂（90mg/m²）于第1天给药，长春新碱（1.5mg/m²）和氟尿嘧啶（600mg/m²）于第3天给药。
21例Ⅰ期或Ⅱ期疾病患者中有19例无病生存（5年精算生存率为90%）。31例Ⅲ期疾病患者中有24例在化疗和手术切除后达到完全缓解（CR）；4年精算DFS为67%。8例Ⅳ期疾病患者中只有1例缓解并存活。
相对短期的CDDP/VCR/FU化疗能为肝母细胞瘤全切患者提供良好的疾病控制。对于初始不可切除疾病的患者，该疗法的缓解率和DFS率与含阿霉素（DOX）的方案相当。
