Chemotherapy for advanced carcinoma of head and neck: an effective outpatient schedule of Cytoxan, Oncovin, methotrexate and bleomycin.
Chemotherapy for advanced carcinoma of head and neck: an effective outpatient schedule of Cytoxan, Oncovin, methotrexate and bleomycin.
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晚期头颈癌化疗：Cytoxan、Oncovin、甲氨蝶呤和博莱霉素的有效门诊方案。
DOI：
10.1002/hed.2890040203
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发表时间：
1981
期刊：
影响因子：
--
通讯作者：
E. Cosentino
中科院分区：
文献类型：
--
作者：
M. Didolkar;J. J. Coleman;E. Elias;W. Gray;E. Cosentino
为了评价一种有效的，细胞周期特异性的联合化疗，可以在门诊的基础上，马里兰州的COMB（环磷酰胺，长春新碱，甲氨蝶呤和博莱霉素）被用于20例IV期头颈部鳞状细胞癌的起源。所有患者均患有不可切除但可测量的疾病。9例患者有远处转移。在此化疗之前，15例（75%）患者接受了放射治疗，12例（60%）接受了根治性手术，3例（15%）接受了其他化疗药物。肿瘤原发部位的分布与我国头颈部鳞状细胞癌的总体分布一致。药物剂量为：环磷酰胺100 mg/m2 p.o.第1-14天，Oncovin 1 mg/m2 IV第1和8天，甲氨蝶呤25 mg/m2 IV第1和8天，博来霉素15单位/m2 IM第1和8天。这个周期每四周重复一次。2例（10%）患者完全缓解，7例（35%）患者部分缓解，因此总缓解率为9例（45%）。7例（35%）患者为静止性疾病，4例（20%）患者为疾病进展。缓解持续时间为8至26+周，中位持续时间为17+周。缓解率与体力状态和既往化疗相关。然而，它与年龄、性别、原发部位、既往放射治疗或肿瘤分化无关。与无应答者（9周）相比，在应答者（中位数16+周）中观察到存活率增加（P < 0.01）。在9例（45%）患者中观察到血液学毒性，导致1例化疗相关死亡。总体而言，这种化疗在门诊患者中耐受性良好。虽然15例（75%）患者接受过既往放射治疗，但结果与其他毒性更大的联合化疗方案相当。
To evaluate an effective, cell-cycle-specific combination chemotherapy which could be administered on an outpatient basis, COMB of Maryland (Cytoxan, Oncovin, methotrexate and bleomycin) was used in 20 patients with stage IV squamous cell carcinoma of head and neck origin. All patients had unresectable but measurable disease. Nine patients had distant metastases. Prior to this chemotherapy, 15 (75%) patients underwent radiation therapy, 12 (60%) had radical surgery, and 3 (15%) were administered other chemotherapeutic drugs. The distribution of the primary site of tumor was identical to the overall distribution of squamous cell carcinoma of head and neck found in this country. Drug dosages were: Cytoxan 100 mg/m2 p.o. days 1-14, Oncovin 1 mg/m2 IV days 1 and 8, methotrexate 25 mg/m2 IV days 1 and 8, and bleomycin 15 units/m2 IM days 1 and 8. This cycle was repeated every four weeks. Two (10%) patients had complete response and 7 (35%) had partial response, thus giving the total response rate of 9 (45%). Seven (35%) patients had static disease and 4 (20%) had progression of disease. Duration of response was from 8 to 26+ weeks with a median duration of 17+ weeks. Response rate was statistically related to performance status and previous chemotherapy. However, it was not related to age, sex, site of origin, previous radiation therapy, or differentiation of the tumor. Increased survival (P < 0.01) was seen in responders (median 16+ weeks) as compared to nonresponders (9 weeks). Hematologic toxicity was seen in 9 (45%) patients, resulting in one chemotherapy-related death. Overall, this chemotherapy has been well tolerated on an outpatient basis. Although 15 (75%) patients received prior radiation therapy, the results were comparable to those obtained by other, more toxic combination chemotherapeutic regimens.