Cisplatin, doxorubicin, and cyclophosphamide plus thoracic radiation therapy for limited-stage unresectable thymoma: An intergroup trial
Cisplatin, doxorubicin, and cyclophosphamide plus thoracic radiation therapy for limited-stage unresectable thymoma: An intergroup trial
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DOI：
10.1200/jco.1997.15.9.3093
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发表时间：
1997-09-01
影响因子：
45.3
通讯作者：
Johnson, D
中科院分区：
文献类型：
--
作者：
Loehrer, PJ;Chen, M;Johnson, D
目的：探讨顺铂、阿霉素、环磷酰胺（PAC）方案治疗局限期不可切除胸腺瘤的疗效。此外，本研究进行了确定的毒性，无进展生存期，并与PAC加放射therapy.Patient和方法的综合治疗的总生存期：组织学诊断为有限阶段不可切除的胸腺瘤或胸腺癌的患者是合格的。进一步的要求包括Karnofsky性能评分> 60，既往未对胸部进行放射治疗，以及足够的骨髓，肝脏和肾脏功能。没有患者既往接受过化疗。患者接受2至4个周期顺铂（每3周重复一次）（50 mg/m（2）），阿霉素（50 mg/m2）和环磷酰胺（500 mg/m2），然后对化疗有稳定、部分或完全反应的患者，对原发肿瘤和局部淋巴结进行总剂量为54戈伊的化疗。从1983年11月至1995年1月，26名患者进入试验。根据病理学审查，3例患者不合格（肺癌、生殖细胞癌、淋巴瘤）。毒性，主要是血液学，是轻微的，只有一个早期死亡，由于穿孔的腹部内脏。在23例可评估的患者中，有5例完全缓解和11例部分缓解（总缓解率为69.6%）。至治疗失败的中位时间为93.2个月（范围：3至99.2+个月），中位生存时间为93个月（范围：1至110个月）。结论：PAC联合化疗治疗局限型胸腺瘤有效率高。联合治疗是可行的，并且与延长的无进展生存期相关。对于不能切除的胸腺瘤患者，联合治疗比单纯放射治疗更有益处。(C)1997年，美国临床肿瘤学会。
Purpose: To determine the response rate of cisplatin plus doxorubicin plus cyclophosphamide (PAC) in patients with limited-stage unresectable thymoma. In addition, this study was undertaken to determine the toxicity, progression-free survival, and overall survival of combined-modality therapy with PAC plus radiation therapy.Patient and Methods: Patients with a histologic diagnosis of limited-stage unresectable thymoma or thymic carcinoma were eligible. Further requirements included a Karnofsky Performance Score of > 60, no prior radiation to the chest, and adequate bone marrow, hepatic, and renal function. No patient had undergone chemotherapy previously. Patients received two to four cycles (repeated every 3 weeks) of cisplatin (50 mg/m(2)), doxorubicin (50 mg/m(2)), and cyclophosphamide (500 mg/m(2)) followed by a total dosage of 54 Gy to the primary tumor and regional lymph nodes for patients with a stable, partial, or complete response to chemotherapy.Results: From November 1983 through January 1995, 26 patients were entered onto the trial. Three patients were ineligible on the basis of pathologic review (lung cancer, germ cell cancer; lymphoma). Toxicity, primarily hematologic, was mild, with only one early death due to a perforated abdominal viscus. Among the 23 assessable patients, there were five complete and 11 partial responses to chemotherapy (overall response rate, 69.6%). The median time to treatment failure was 93.2 months (range, 3 to 99.2+ months), and the median survival time was 93 months (range, 1 to 110 months). The 5-year survival rate is 52.5%.Conclusions: PAC combination chemotherapy produces response rates in the management of patients with limited thymoma. Combined-modality therapy is feasible and associated with prolonged progressive-free survival. The benefit af combined-modality therapy over radiation therapy alone is suggested for patients with unresectable thymoma. (C) 1997 by American Society of Clinical Oncology.