Vuoristo M S
Medical School, University of Tampere, Finland.
Melanoma Res. 1996 Aug;6(4):331-6. doi: 10.1097/00008390-199608000-00009.
One hundred and one patients with metastatic melanoma were treated with three different dacarbazine (DTIC)-based polychemotherapy plus recombinant interferon (IFN) alpha-2b regimens in multicentre phase II trials in Finland during 1986-1993. The regimens were DTIC, nimustine (ACNU) plus IFN and two different schedules of DTIC, vincristine, bleomycin, lomustine (CCNU) plus IFN. There were 14 patients with complete response (CR) and 12 patients with partial response, with estimated median survivals of 44 months and 13 months respectively. The median survival was 14 months for 22 patients with stable disease, and 6 months for the 53 patients who had progressive or non-evaluable disease. The median progression-free interval was 6 months and the median survival 9 months for the whole group. Thirty-nine percent of patients survived at least 1 year and 17% at least 2 years. Age, sex, primary tumour site, Clark's level, disease-free interval, prior therapy of recurrence and metastatic sites of patients who achieved CR were compared with those of other patients. In addition, the predictive value of these factors for survival was analysed. Prior therapy of recurrent disease (none, surgery or surgery plus radiotherapy) and metastatic profile (soft tissue or lung, one or two sites) were associated with CR in univariate analysis, while in multivariate analysis only prior therapy was found to be an independent prognostic factor. Prior surgery plus radiotherapy, soft tissue or lung metastases and response to present chemo-immunotherapy were significant predictors of favourable survival in univariate analysis. In multivariate analysis only response was an independent prognostic factor.
1986年至1993年期间，在芬兰进行的多中心II期试验中，101例转移性黑色素瘤患者接受了三种不同的以达卡巴嗪（DTIC）为基础的联合化疗加重组干扰素（IFN）α-2b方案治疗。这些方案包括DTIC、尼莫司汀（ACNU）加IFN，以及两种不同给药方案的DTIC、长春新碱、博来霉素、洛莫司汀（CCNU）加IFN。有14例患者完全缓解（CR），12例患者部分缓解，估计中位生存期分别为44个月和13个月。22例病情稳定的患者中位生存期为14个月，53例病情进展或不可评估的患者中位生存期为6个月。整个组的中位无进展生存期为6个月，中位生存期为9个月。39%的患者至少存活1年，17%的患者至少存活2年。将达到CR的患者的年龄、性别、原发肿瘤部位、克拉克分级、无病间期、复发的既往治疗情况和转移部位与其他患者进行了比较。此外，还分析了这些因素对生存的预测价值。在单变量分析中，复发病变的既往治疗情况（无、手术或手术加放疗）和转移情况（软组织或肺部、一个或两个部位）与CR相关，而在多变量分析中，仅发现既往治疗是一个独立的预后因素。在单变量分析中，既往手术加放疗、软组织或肺部转移以及对当前化学免疫治疗的反应是良好生存的重要预测因素。在多变量分析中，只有反应是一个独立的预后因素。
