Comparison of intrathecal chemotherapy for leptomeningeal carcinomatosis of a solid tumor: Methotrexate alone versus methotrexate in combination with cytosine arabinoside and hydrocortisone
Comparison of intrathecal chemotherapy for leptomeningeal carcinomatosis of a solid tumor: Methotrexate alone versus methotrexate in combination with cytosine arabinoside and hydrocortisone
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DOI：
10.1093/jjco/hyg118
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发表时间：
2003-12-01
影响因子：
2.4
通讯作者：
Kim, NK
中科院分区：
文献类型：
--
作者：
Kim, DY;Lee, KW;Kim, NK
目的：比较鞘内甲氨蝶呤单药治疗与三药联合治疗软脑膜癌病患者的疗效。方法：对55例经病理证实的实体瘤软脑膜癌病患者进行病理学反应评价。 M 组 (n = 29) 接受甲氨蝶呤 15 mg，MHA 组 (n = 26) 接受甲氨蝶呤 15 mg、氢化可的松 15 mg/m(2) 和 ara-C 30 mg/m(2)，每周两次鞘内注射，直至获得细胞学反应。 结果：肿瘤的原发部位是肺 (n = 33)、乳腺 (n = 13) 和胃 (n 5）。 45例患者病理均为腺癌。 MHA组鞘内化疗的细胞学有效率显着高于M组（38.5% vs 13.8%，P=0.036）。 MHA组的中位生存期为18.6周，M组的中位生存期为10.4周（P = 0.029）。结论：甲氨蝶呤、阿糖胞苷和氢化可的松联合鞘内化疗治疗实体瘤软脑膜癌病的疗效优于甲氨蝶呤单药治疗。
Objective: To compare the efficacy of intrathecal methotrexate single therapy with three-drug combination therapy in patients with leptomeningeal carcinomatosis.Methods: Fifty-five patients who had pathologically proven leptomeningeal carcinomatosis of a solid tumor were evaluated in terms of pathological response. Group M (n = 29) received methotrexate 15 mg and group MHA (n = 26) received methotrexate 15 mg, hydrocortisone 15 mg/m(2) and ara-C 30 mg/m(2) twice a week intrathecally until a cytological response was obtained.Results: Primary sites of the tumor were the lung (n = 33), breast (n = 13) and stomach (n 5). The pathology of 45 patients was adenocarcinoma. The cytological response rate to intrathecal chemotherapy was significantly higher in the MHA group than in the M group (38.5 vs 13.8%, P= 0.036). The median survival was 18.6 weeks in the MHA arm and 10.4 weeks in the M arm (P = 0.029).Conclusion: Combination intrathecal chemotherapy with methotrexate, cytosine arabinoside and hydrocortisone showed more favorable effects than methotrexate single therapy for leptomeningeal carcinomatosis in solid tumors.