MALIGNANT PHEOCHROMOCYTOMA - EFFECTIVE TREATMENT WITH A COMBINATION OF CYCLOPHOSPHAMIDE, VINCRISTINE, AND DACARBAZINE
MALIGNANT PHEOCHROMOCYTOMA - EFFECTIVE TREATMENT WITH A COMBINATION OF CYCLOPHOSPHAMIDE, VINCRISTINE, AND DACARBAZINE
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DOI：
10.7326/0003-4819-109-4-267
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发表时间：
1988-08-15
影响因子：
39.2
通讯作者：
KEISER, HR
中科院分区：
文献类型：
--
作者：
AVERBUCH, SD;STEAKLEY, CS;KEISER, HR
研究目的：探讨联合化疗治疗晚期恶性嗜铬细胞瘤的疗效和毒副反应。设计：非随机、单组试验。单位：政府医疗转诊中心。患者：14例经组织学检查证实的恶性嗜铬细胞瘤患者。所有患者均有转移性疾病和尿儿茶酚胺分泌升高。干预措施：优化降压治疗后，患者接受环磷酰胺，第1天750 mg/m2体表面积;长春新碱，第1天1.4 mg/m2，达卡巴嗪，第1天和第2天600 mg/m2，每21天一次。测量和主要结果：环磷酰胺、长春新碱和达卡巴嗪联合化疗的完全和部分缓解率为57%（中位持续时间为21个月;范围为7至超过34个月）。在79%的患者中观察到完全和部分生化反应（中位持续时间超过22个月;范围为6至超过35个月）。所有应答患者的体能状态和血压均有客观改善。毒性包括化疗的预期血液学、神经学和胃肠道效应，无严重后遗症。有4次轻微高血压发作和1次轻微高血压发作。结论：环磷酰胺、长春新碱、达卡巴嗪联合化疗是治疗晚期恶性嗜铬细胞瘤的有效方法。尿中的儿茶酚胺可用于确定治疗的生化反应。
Study Objective: To determine the efficacy and toxicity of combination chemotherapy in patients with advanced, malignant pheochromocytoma. Design: Nonrandomized, single-arm trial. Setting: Governmental medical referral center. Patients: Fourteen patients with malignant pheochromocytoma confirmed by histologic tests. All patients had metastatic disease and elevated urinary catecholamine secretion. Interventions: After optimization of antihypertensive therapy, patients received cyclophosphamide, 750 mg/m2 body surface area on day 1; vincristine, 1.4 mg/m2 on day 1, and dacarbazine, 600 mg/m2 on days 1 and 2, every 21 days. Measurements and Main Results: Combination chemotherapy with cyclophosphamide, vincristine, and dacarbazine produced a complete and partial response rate of 57% (median duration, 21 months; range, 7 to more than 34). Complete and partial biochemical responses were seen in 79% of patients (median duration, more than 22 months; range, 6 to more than 35). All responding patients had objective improvement in performance status and blood presssure. Toxicity included expected hematologic, neurologic, and gastrointestinal effects of chemotherapy without serious sequelae. There were four minor hypotensive episodes and one minor hypertensive episode. Conclusions: Combination chemotherapy with cyclophosphamide, vincristine, and dacarbazine is effective for advanced malignant pheochromocytoma. Urinary catecholamines are useful to ascertain biochemical response to therapy.