Intensive sequential chemotherapy with bleomycin, Oncovin, mitomycin C, and methotrexate followed by adriamycin, cisplatin, and cyclosphosphamide in squamous cell cancer of the head and neck.
Intensive sequential chemotherapy with bleomycin, Oncovin, mitomycin C, and methotrexate followed by adriamycin, cisplatin, and cyclosphosphamide in squamous cell cancer of the head and neck.
复制标题
在头颈部鳞状细胞癌中，使用博莱霉素、Oncovin、丝裂霉素 C 和甲氨蝶呤进行强化序贯化疗，然后使用阿霉素、顺铂和环磷酰胺。
DOI：
10.1002/mpo.2950110104
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发表时间：
1983
期刊：
影响因子：
--
通讯作者：
W. Ensminger
中科院分区：
文献类型：
--
作者：
R. Wheeler;S. Baker;M. Liepman;W. Ensminger
26 名晚期头颈部鳞状细胞癌患者接受了博莱霉素、Oncovin、丝裂霉素 C 和甲氨蝶呤 (BOMM) 治疗 10 周。然后，部分反应者和无反应者按照计划的序贯方案接受阿霉素、顺铂和环磷酰胺 (APC)。 BOMM 的缓解率为 65%（19% 完全缓解，CR）。 APC 的总体响应率为 20%。 BOMM 的八个无响应者中只有三人可以收到 APC 并且没有响应。七名部分响应者中有六人收到了 APC，但只有一名响应。一名对 BOMM 完全缓解的患者在复发时接受了 APC，并获得了部分缓解。 BOMM 的主要副作用是粘膜炎和骨髓抑制。输注博来霉素后 60-72 小时接受甲氨蝶呤的患者比输注博莱霉素 36-42 小时后接受甲氨蝶呤的患者骨髓抑制更少。 APC 的毒性包括恶心、呕吐和骨髓抑制。包括之前的系列在内，共有 45 名患者接受了 BOMM 治疗，缓解率为 71%（之前接受过放射治疗的患者为 69%）。 28% 的既往治疗患者获得完全缓解，其中两名患者在 31 个月和 37 个月时没有疾病。与每周甲氨蝶呤给药相比，每周两次将甲氨蝶呤剂量率改为低剂量，然后单剂量口服亚叶酸并没有改善完全或部分缓解率。计划序贯使用这种含顺铂的方案也没有改善完全缓解率和缓解持续时间。
Twenty-six patients with advanced squamous cell cancer of the head and neck were treated with bleomycin, Oncovin, mitomycin C, and methotrexate (BOMM) for ten weeks. Partial and nonresponders then received adriamycin, cisplatin, and cyclophosphamide (APC) in a planned sequential program. The response rate to BOMM was 65% (19% complete remission, CR). The overall response rate to APC was 20%. Only three of eight nonresponders to BOMM could receive APC and non responded. Six of seven partial responders received APC and only one responded. One complete responder to BOMM received APC at relapse and attained a partial response. The major side effects of BOMM were mucositis and myelosuppression. Patients receiving methotrexate 60-72 hours following the bleomycin infusion had less myelosuppression than patients who were treated 36-42 hours after bleomycin. The toxicities with APC included nausea, vomiting, and myelosuppression. Including a prior series, a total of 45 patients have been treated with BOMM with a 71% response rate (69% in previously irradiated patients). Twenty-eight percent of previously treated patients achieved complete remission, and two of these patients are disease free at 31 and 37 months. Methotrexate dose-rate alteration to low dose twice weekly followed by a single dose of oral leucovorin did not improve the complete or partial response rate when compared to weekly methotrexate administration. The complete remission rate and response duration were also not improved by the planned sequential use of this cisplatin-containing regimen.