Casali P, Pastorino U, Azzarelli A, Bertulli R, Zucchinelli P, Devizzi L, Santoro A
Division of Medical Oncology, Istituto Nazionale Tumori, Milan, Italy.
Cancer Chemother Pharmacol. 1993;31 Suppl 2:S228-32.
Doxorubicin and ifosfamide are currently the two main drugs for the treatment of soft tissue sarcomas in adults. Given in combination at full doses, with or without dacarbazine, these agents have induced higher response rates than were obtained with single-agent therapy. Because they involve considerable myelotoxicity, however, full-dose regimens should be reserved for patients with good performance status and without potential septic foci. Obviously, higher response rates do not automatically translate into improved survival. In soft tissue sarcomas, full-dose polychemotherapy will most probably provide a survival benefit only in selected patients in whom surgery can be performed in combination with chemotherapy. Prospective trials in such patients, although difficult to carry out, would be highly desirable. The information they would provide might help the clinician tailor treatment in a more rational way and improve chances of cure or long-term survival in at least some patient subgroups.
多柔比星和异环磷酰胺是目前治疗成人软组织肉瘤的两种主要药物。全剂量联合使用这两种药物，无论是否加用达卡巴嗪，其诱导的缓解率均高于单药治疗。然而，由于它们具有相当大的骨髓毒性，全剂量方案应仅用于身体状况良好且无潜在感染灶的患者。显然，较高的缓解率并不会自动转化为生存改善。在软组织肉瘤中，全剂量多药化疗很可能仅对某些可接受手术联合化疗的特定患者有生存益处。对此类患者进行前瞻性试验虽然很难开展，但却是非常必要的。试验所提供的信息可能有助于临床医生更合理地制定治疗方案，并至少在某些患者亚组中提高治愈或长期生存的机会。
