Elias A D
Department of Medicine, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.
Clin Orthop Relat Res. 1993 Apr(289):94-105.
Single-agent and combination chemotherapy have greater than 20% single-agent activity: doxorubicin and ifosfamide. Certain other anthracycline analogues possess similar activity. It remains a question whether combination therapy is any better than single-agent doxorubicin. Randomized trials have demonstrated enhanced response rates and increased toxicity for the combinations, but survival, with limited follow-up data, is not improved. The role of adjuvant chemotherapy also is not yet established. Two of 12 trials demonstrate survival benefits; however, most show a delay in relapse with about a 10% risk of irreversible toxicity. New agents, targets, and methods to circumvent resistance mechanisms developed in the laboratory are necessary to advance the field.
单药化疗和联合化疗具有超过20%的单药活性：多柔比星和异环磷酰胺。某些其他蒽环类类似物具有相似的活性。联合治疗是否比单药多柔比星治疗效果更好仍是一个问题。随机试验表明联合治疗的缓解率提高且毒性增加，但由于随访数据有限，生存率并未提高。辅助化疗的作用也尚未确立。12项试验中有两项显示出生存获益；然而，大多数试验显示复发延迟，有大约10%的不可逆毒性风险。需要新的药物、靶点以及规避实验室中产生的耐药机制的方法来推动该领域的发展。
