Phase I and II study of high-dose ifosfamide, carboplatin, and etoposide with autologous bone marrow rescue in lymphomas and solid tumors.
Phase I and II study of high-dose ifosfamide, carboplatin, and etoposide with autologous bone marrow rescue in lymphomas and solid tumors.
复制标题
高剂量异环磷酰胺、卡铂和依托泊苷在淋巴瘤和实体瘤中自体骨髓挽救的 I 期和 II 期研究。
DOI：
10.1200/jco.1992.10.11.1712
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发表时间：
1992
期刊：
影响因子：
--
通讯作者：
R. Wittes
中科院分区：
文献类型：
--
作者：
W. Wilson;V. Jain;G. Bryant;K. Cowan;C. Carter;M. Cottler;B. Goldspiel;S. Steinberg;D. Longo;R. Wittes
目的
大剂量化疗可使少数耐药淋巴瘤和实体瘤患者获得持久的无病缓解。为了改善现有方案，选择异环磷酰胺、卡铂和依托泊苷（ICE）作为新的高剂量方案，因为它们具有良好的非造血毒性谱和体外系统协同作用的证据。
患者和方法
41名患有耐药性霍奇金淋巴瘤和非霍奇金淋巴瘤以及乳腺癌和睾丸癌的患者进入I期和II期试验，即单疗程ICE与自体骨髓挽救。移植前，所有患者接受联合化疗，直到达到最大肿瘤反应。
结果
患者在4天内接受总剂量为10 - 18 g/m2的异环磷酰胺、0.9 - 1.98 g/m2的卡铂和0.6 - 1.5 g/m2的依托泊苷给药，最大耐受剂量（MTD）为异环磷酰胺16 g/m2、卡铂1.8 g/m2和依托泊苷1.5 g/m2。剂量限制性毒性包括不可逆的肾脏、心脏和CNS功能障碍。有3例中毒性死亡（7%），均发生在MTD以上。13例接受MTD治疗的患者对该方案耐受良好;通常观察到可逆性肾功能不全和2级粘膜炎。在23名在移植时患有持续性疾病的重度预治疗患者中，10名（43%）达到完全缓解（CR），11名（48%）达到部分缓解（PR）。接受MTD或低于MTD治疗的霍奇金和非霍奇金淋巴瘤患者的中位潜在随访时间为11.9个月，12个月无进展生存率分别为62%和48%。
结论
高剂量ICE联合骨髓拯救耐受性良好，应答率高，应考虑进一步检测。
PURPOSE
High-dose chemotherapy produces durable disease-free remissions in a minority of patients with resistant lymphomas and solid tumors. In an attempt to improve on the available regimens, ifosfamide, carboplatin, and etoposide (ICE) were selected for a new high-dose regimen because of their favorable spectrum of nonhematopoietic toxicity and evidence of synergy in in vitro systems.
PATIENTS AND METHODS
Forty-one patients with drug-resistant Hodgkin's and non-Hodgkin's lymphomas, and breast and testicular cancers were entered onto a phase I and II trial of a single course of ICE with autologous bone marrow rescue. Before transplantation, all patients received combination chemotherapy until maximal tumor response was achieved.
RESULTS
Patients received total doses of ifosfamide from 10 to 18 g/m2, carboplatin from 0.9 to 1.98 g/m2, and etoposide from 0.6 to 1.5 g/m2 administered during a 4-day period, with a maximum-tolerated dose (MTD) of ifosfamide 16 g/m2, carboplatin 1.8 g/m2, and etoposide 1.5 g/m2. The dose-limiting toxicities included irreversible renal, cardiac, and CNS dysfunction. There were three toxic deaths (7%), and all occurred above the MTD. Thirteen patients who were treated at the MTD tolerated the regimen well; reversible renal dysfunction and grade 2 mucositis commonly were observed. Of 23 heavily pretreated patients with persistent disease at the time of transplant, 10 (43%) achieved complete remissions (CRs) and 11 (48%) achieved partial remissions (PRs). Hodgkin's and non-Hodgkin's lymphoma patients who were treated at or below the MTD had a median potential follow-up of 11.9 months, and 12-month progression-free survivals of 62% and 48%, respectively.
CONCLUSION
High-dose ICE with bone marrow rescue was well tolerated with a high response rate, and should be considered for further testing.
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影响因子：
11.2
作者：
E. Frei;B. Teicher;S. Holden;K. Cathcart;Yenyun Wang
通讯作者：
E. Frei;B. Teicher;S. Holden;K. Cathcart;Yenyun Wang
用异环磷酰胺/美司钠治疗儿童患者后的中枢神经系统毒性。
DOI：
10.1200/jco.1986.4.8.1253
发表时间：
1986
期刊：
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
影响因子：
--
作者：
Pratt,CB;Green,AA;Horowitz,ME;Meyer,WH;Etcubanas,E;Douglass,E;Hayes,FA;Thompson,E;Wilimas,J;Igarashi,M
通讯作者：
Igarashi,M
高剂量环磷酰胺、卡莫司汀和依托泊苷以及自体骨髓移植治疗复发性霍奇金病。
影响因子：
39.2
作者：
Jagannath,S;Dicke,KA;Armitage,JO;Cabanillas,FF;Horwitz,LJ;Vellekoop,L;Zander,AR;Spitzer,G
通讯作者：
Spitzer,G
影响因子：
45.3
作者：
NICHOLS, CR;TRICOT, G;JANSEN, J
通讯作者：
JANSEN, J