Treatment of malignant mesothelioma with methotrexate and vinblastine, with or without platinum chemotherapy
Treatment of malignant mesothelioma with methotrexate and vinblastine, with or without platinum chemotherapy
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DOI：
10.1378/chest.109.5.1239
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发表时间：
1996-05-01
期刊：
影响因子：
9.6
通讯作者：
Livingston, RB
中科院分区：
文献类型：
--
作者：
Hunt, KJ;Longton, G;Livingston, RB
研究目的：探讨甲氨蝶呤、长春碱和铂化疗治疗弥漫性不可切除恶性间皮瘤的疗效。设计：对组织学证实的恶性间皮瘤患者进行甲氨蝶呤、长春碱和顺铂化疗的评估。如果患者先前存在愈合损失或神经病变，或明显残疾（例如，在床上或椅子上花费超过半天），则暂停顺铂治疗。环境：所有患者最初在华盛顿大学医学中心进行评估，并在华盛顿大学或社区接受化疗。干预措施：1990年至1994年间，17名患者接受了这种化疗。10例患者接受顺铂100mg /m(2) IV（第1天），甲氨蝶呤30mg /m(2) IV（第8、15和22天），长春花碱3mg /m(2) IV（第8、15和22天），以28天为周期。一名患者由于先前存在的听力损失而用卡铂代替顺铂。6名患者每周接受相同剂量的甲氨蝶呤和长春花碱治疗，不含铂。测量和结果：17例患者中有9例（53%；95%可信区间[C]， 28 - 77%）缓解，包括2例完全缓解，2例部分缓解和5例回归。中位进展时间为8个月。所有患者的中位生存时间为14个月。预计2年生存率为35% （95% CI, 12 - 60%）。结论：虽然本研究中患者数量较少，但有效率和预计2年生存率为35%，优于不可切除恶性间皮瘤的典型报道。有必要在确认性试验中进行进一步调查。
Study objective: To determine the efficacy of methotrexate, vinblastine, and platinum chemotherapy in patients with diffuse unresectable malignant mesothelioma.Design: Patients with histologically confirmed malignant mesothelioma were evaluated for treatment with methotrexate, vinblastine, and cisplatin chemotherapy. If the patient had preexisting healing loss or neuropathy, of was significantly disabled (eg, spending greater than half of the day in bed or a chair), cisplatin therapy was withheld.Setting: All patients were initially evaluated at the University of Washington Medical Center and received chemotherapy at the University of Washington or in the community.Interventions: Between 1990 and 1994, 17 patients received this chemotherapy. Ten patients received cisplatin, 100 mg/m(2) IV on day 1, methotrexate, 30 mg/m(2) IV on days 8, 15, and 22, and vinblastine, 3 mg/m(2) IV on days 8, 15, and 22, in 28-day cycles. One patient had carboplatin substituted for cisplatin due to preexisting hearing loss. Six patients received weekly methotrexate and vinblastine at the same doses without platinum.Measurements and results: Nine of the 17 (53%; 95% confidence interval [C], 28 to 77%) patients responded, including two complete remissions, two partial remissions, and five regressions. Median time to progression is 8 months. The median survival time for all patients is 14 months. Projected 2-year survival is 35% (95% CI, 12 to 60%).Conclusions: Although the number of the patients in this study is small, the response rate and projected 2-year survival of 35% are better than those typically reported for unresectable malignant mesothelioma. Further investigation is warranted in confirmatory trials.