PRELIMINARY-RESULTS OF M-VAC (METHOTREXATE, VINBLASTINE, DOXORUBICIN AND CISPLATIN) FOR TRANSITIONAL CELL-CARCINOMA OF THE UROTHELIUM
PRELIMINARY-RESULTS OF M-VAC (METHOTREXATE, VINBLASTINE, DOXORUBICIN AND CISPLATIN) FOR TRANSITIONAL CELL-CARCINOMA OF THE UROTHELIUM
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DOI：
10.1016/s0022-5347(17)48996-8
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发表时间：
1985-01-01
影响因子：
6.6
通讯作者：
WHITMORE, WF
中科院分区：
文献类型：
--
作者：
STERNBERG, CN;YAGODA, A;WHITMORE, WF
采用甲氨蝶呤、长春碱、阿霉素和顺铂（M-VAC）方案治疗25例尿路移行细胞癌。治疗包括Mo。30 mg/m2甲氨蝶呤的周期，24小时后3 mg/m2长春碱，30 mg/m2阿霉素和70 mg/m2顺铂，并在第15和22天重复长春碱和甲氨蝶呤结束。在71%的患者中观察到显著的肿瘤消退。24例患者中有12例（50%，95%置信限30-70%）观察到完全临床缓解，其中6例经病理证实。手术探查后，4例患者需要降级至部分缓解。中位缓解持续时间尚未达到9.5个月以上，范围是4.5加16加5例患者（21%）在4-8个月以上的时间内获得部分临床缓解，1例有轻微反应，持续4个月。1例病情稳定11 mo。所有转移部位均缓解，包括骨（8例中的6例）、肝（5例中的3例）、局部（17例中的12例）和膀胱内（7例中的6例）疾病。毒性包括中重度骨髓抑制，导致4例患者出现最低败血症，1例患者出现药物相关死亡，轻度至中度厌食、呕吐、脱发和肾功能不全。显然，用甲氨蝶呤、长春碱、阿霉素和顺铂治疗对局部和播散性尿路肿瘤非常有效，预期（95%置信限）在53-89%的病例中诱导客观肿瘤消退。
The M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin) regimen was used to treat 25 patients with transitional cell carcinoma of the urothelial tract. Treatment consisted of mo. cycles fo 30 mg/m2 methotrexate, followed 24 h later by 3 mg/m2 vinblastine, 30 mg/m2 doxorubicin and 70 mg/m2 cisplatin, and concluded with repeat vinblastine and methotrexate on days 15 and 22. Significant tumor regression was noted in 71% of the patients. Complete clinical remission was observed in 12 of 24 patients (50%, 95% confidence limits 30-70%) with bidimensionally measurable indicator lesions, 6 of whom had pathological confirmation. After surgical exploration 4 patients required downstaging to a partial remission. The median duration of response has not yet been reached at 9.5 plus mo., range 4.5 plus - 16 plus. Five patients (21%) had a partial clinical remission of 4-8 plus mo., 1 had a minor response for 4 mo. and 1 had stable disease for 11 mo. All metastatic sites responded, including bone (6 of 8 cases), liver (3 of 5), locoregional (12 of 17) and intravesical (6 of 7) disease. Toxicity included moderately severe myelosuppression that resulted in nadir sepsis in 4 patients and a drug-related death in 1, mild to moderate anorexia, vomiting, alopecia and renal dysfunction. Apparently, treatment with methotrexate, vinblastine, doxorubicin and cisplatin is extremely effective against locoregional and disseminated urothelial tract tumors, with the expectation (95% confidence limits) of inducing objective tumor regression in 53-89% of the cases.