APP和VPP联合方案治疗晚期食管癌30例分析

目的：探讨晚期食管ＡＰＰ方案治疗的疗效与毒副作用。方法：ＡＰＰ方案（ＡＤＭ＋ＰＹＭ＋ＰＤＤ）与ＶＰＰ方案（ＶＣＲ＋ＰＹＭ＋ＰＤＤ）对照。结果：ＡＰＰ方案治疗１５例，ＣＲ５例（３３．３３％），ＰＲ４例（２６．７％），Ｓ５例（３３．３％），Ｐ１例（６．７％），有效率（ＣＲ－ＰＲ）６０％。ＶＰＰ方案治疗１５例，ＰＲ８例（５３．３％），Ｓ５例（３３．３％），Ｐ２例＊（１３．４％），有效率（ＣＲ＋ＰＲ）５３     

以异环磷酰胺为主治疗晚期肺癌42例疗效观察

目的　探讨以异环磷酰胺（ＩＦＯ） 为主的化疗方案治疗晚期肺癌的疗效。方法　４２ 例晚期肺癌,ＳＣＬＣ组１９ 例,ＮＳＣＬＣ组２３ 例,ＳＣＬＣ组以ＩＥ方案（ＩＦＯ＋ Ｖｐ －１６） 、ＮＳＣＬＣ组以ＩＶＰ方案（ＩＦＯ＋ ＶＤＳ＋ ＰＤＤ） 。结果　全组病人有５ 例达ＣＲ,１５ 例达ＰＲ,总有效率（ＲＲ）４０－４７ ％ 。其中ＳＣＬＣ组ＲＲ 为６３－１５％ ,ＮＳＣＬＣ组ＲＲ为３４－７８ ％ 。本组毒性反应轻微。结论　以ＩＦＯ为主的化疗方案治疗晚期肺癌疗效显著,毒性较小,可作为二线治疗方案。     

COMP与PBM化疗方案治疗晚期鼻咽癌的疗效分析

我们以ＣＴＸ＋ＶＣＲ＋ＭＴＸ＋ＤＤＰ（ＣＯＭＰ）和ＤＤＰ＋ＢＬＭ＋ＭＴＸ（ＰＢＭ）两种化疗方案治疗复发和转移的晚期鼻咽癌５８例，４９例可评价客观疗效。结果ＣＯＭＰ组取得了ＣＲ３例，ＰＲ９例，有效率（ＣＲ＋ＰＲ）为５２．２％；ＰＢＭ组ＣＲ１例，ＰＲ９例，有效率（ＣＲ＋ＰＲ）为３８．５％。两者无显著性差异（Ｐ〉０．０５）。治疗后有效病例缓解期为５～５６月，中位缓解期为２５月。两种方案对鼻咽癌肺转移均较     

以异环磷酰胺为主治疗晚期肺癌42例疗效观察

目的 探讨以异环磷酰胺（ＩＦＯ）为主的化疗方案治疗晚期肺癌的疗效。方法 ４２例晚期肺癌,ＳＣＬＣ组１９例,ＮＳＣＬＣ组２３例,ＳＣＬＣ组以ＩＥ方案（ＩＦＯ＋Ｖｐ－１６）、ＮＳＣＬＣ组以ＩＶＰ方案（ＩＦＯ＋ＶＤＳ＋ＰＤＤ）。结果 全组病人有５例达ＣＲ,１５例达ＰＲ,总有效率（ＲＲ）４０．４７％。其中ＳＣＬＣ组ＲＲ为６３．１５％,ＮＳＣＬＣ组ＲＲ为３４．７８％。本组毒性反应轻微结论以ＩＦＯ为主的化疗方     

COMP和PBM化疗方案治疗晚期鼻咽癌的疗效分析

我们以ＣＴＸ＋ＶＣＲ＋ＭＴＸ＋ＤＤＰ（ＣＯＭＰ）和ＤＤＰ＋ＢＬＭ＋ＭＴＸ（ＰＢＭ）两种化疗方案治疗复发和转移的晚期鼻咽癌５８例。４９例可评价客观疗效。结果ＣＯＭＰ组取得ＣＲ３例、ＰＲ９例，有效率（ＣＲ＋ＰＲ）为５２．２％；ＰＢＭ组ＣＲ１例、ＰＲ９例，有效率（ＣＲ＋ＰＲ）为３８．５％。两者无显著性差异（Ｐ＞０．０５）．治疗后有效病例缓解期为５～５６月，中位缓解期为２５月。两种方案对鼻咽癌肺转移均较好，对肝转移疗效最差。ＣＯＭＰ方案对鼻咽癌远处转移疗效较好，对肺转移有效率为５８．３％（７／１２）．可作为鼻咽癌远处转移尤其是肺转移的首选。ＰＢＭ方案对鼻咽癌原灶复发疗效较好，对鼻咽癌复发有效率为４２．９％（３／７），可作为鼻咽癌原灶复发或放射治疗后辅助化疗首选方案。     

VIP方案加放射治疗晚期非小细胞肺癌的近期疗效观察

目的：评估ＶＩＰ方案化疗与放射治疗晚期非小细胞肺癌（ＮＳＣＬＣ）的近期疗效。方法：观察１９９７年２月～１９９９年２月收治的３３例晚期非小细胞肺癌患。化疗以ＶＩＰ方案为主,２～４周期后行放射治疗,放疗剂量ＤＴ５０～７０Ｇｙ／５～７周。结果：完全缓解（ＣＲ）率为１５．２％,部分缓解率（ＰＲ）为５１．５％,总有效率（ＣＲ＋ＰＲ）为６６．７％。毒副反应主要为Ⅰ～Ⅱ度消化道反应、骨髓抑制及脱发。结论：ＶＩ     

MVP方案治疗晚期非小细胞肺癌

目的：观察丝裂霉素（ＭＭＣ）、长春花碱酰胺（ＶＤＳ）和顺铂（ＰＤＤ）组成的ＭＶＰ方案治疗非小细胞肺癌的疗效及副作用。方法：４２例晚期非小细胞肺癌患者接受ＭＶＰ方案治疗,每例至少２个周期,按ＷＨＯ疗效及毒性标准进行评价。结果：ＭＶＰ方案对非小细胞肺癌的有效率为４２．９％,主要毒性反应为骨髓抑制,其次为发及周围神经炎,其他系统毒性均较轻。结论ＭＶＰ方案对非小细胞肺癌疗效较高,毒性反应较轻,可以作为治疗     

多西他赛单药治疗老年晚期非小细胞肺癌的临床观察

目的：观察多西他赛单药治疗晚期非小细胞肺癌（ＮＳＣＬＣ）老年患者的临床疗效和不良反应。方法：４２例晚期ＮＳＣＬＣ初治老年患者予以多西他赛７０ｍｇ／ｍ^２治疗,２１天为１周期,治疗２～４周期,随访至疾病进展和死亡。结果：ＣＲ１例,ＰＲ９例,ＳＤ１３例,ＰＤ１７例,总有效率（ＣＲ＋ＰＲ）３５.０％,疾病控制率（ＣＲ＋ＰＲ＋ＳＤ）５７.５％,中位无进展生存期４.２个月,中位生存期６.１个月,１年生存率为３５.８％。主要毒副反应为骨髓抑制和血小板减少。结论：多西他赛单药治疗老年晚期ＮＳＣＬＣ有效且耐受性好。     

MVP方案联合放疗治疗晚期非小细胞肺癌的近期疗效观察

目的：评价ＭＶＰ（丝裂霉素、长春地辛、顺铂）方案联合放疗治疗晚期非小细胞肺癌的近期疗效。方法：５２例晚期非小细胞肺癌患者采用ＭＶＰ方案化疗并加用＾６０Ｃｏ照射。化疗２个周期,胸部放疗总量６０Ｇｙ,远处转移灶的放疗量视病灶部位而定。结果：２５例完全缓解（ＣＲ）,１７例获部分缓解（ＰＲ）,有效率为８０．８％（ＣＲ＋ＰＲ）。对最初化疗敏感的病例疗效好,尤其ＣＲ率较高,结论：ＭＶＰ方案与放疗联用能明显提高     

ADMV方案治疗中晚期非小细胞肺癌62例近期疗效分析

采用ＡＤＭＶ（ＡＤＭ＋ＤＤＰ＋ＭＭＣ＋ＭＭＣ＋ＶＰ－１６）方案联合化疗，对６２例中晚期非小细胞肺癌近期疗效观察，ＣＲ２例，ＰＲ１８例，ＮＲ３２例，ＰＤ１０例，总有效率（ＣＲ＋ＰＲ）３２．２６％（２０／６２）。化疗毒副反应主要是消化道反应（５９．６８％）及骨髓抑制（白细胞下降占６１．２９％）。     

长春瑞滨联合顺铂治疗既往使用紫杉类的晚期非小细胞肺癌临床分析

目的　评价长春瑞滨联合顺铂治疗既往使用紫杉类的晚期非小细胞肺癌的疗效和毒性。方法　 3 0例既往紫杉类药物治疗过的ⅢB或Ⅳ期非小细胞肺癌患者 ,体能状况评分 (ECOG) 0～ 1分。 15例用NP方案 (长春瑞滨 +顺铂 )治疗 ,15例用MVP方案 (丝裂霉素 +长春地辛 +顺铂 )治疗。结果　NP组和MVP组有效率分别为 13 .3 %和 0 (P >0 .0 5)。NP组患者疾病进展时间较MVP组长(分别为 6个月和 3个月 ,P <0 .0 5) ,NP组中位生存时间较MVP组长 (分别为 9个月和 6个月 ,P <0 .0 5) ,NP组 1年生存率 (40 .0 % )明显高于对照组 (0 ,P <0 .0 5)。两组Ⅲ、Ⅳ度不良反应差异无显著性 (P >0 .0 5) ,患者可以耐受。结论　NP方案对既往使用紫杉类的、体能状况较好的晚期非小细胞肺癌患者有一定疗效 ,可使患者疾病进展推迟 ,中位生存期延长 ,1年生存率提高 ,且毒性可耐受     

Mitomycin C plus vindesine or cisplatin plus epirubicin in previously treated patients with symptomatic advanced non-small-cell lung cancer

Summary A total of 40 previously treated patients with symptomatic advanced non-small-cell lung cancer (NSCLC) were subjected to second-line chemotherapy with mitomycin C plus vindesine (MV) or cisplatin plus epirubicin (PE). The 12 patients treated with the MV regimen showed no objective response (OR) or symptom palliation. In the 28 patients who received the PE regimen, we obtained a 25% partial response rate, with amelioration of tumor-related symptoms occurring in 35.7% of cases and improvement in the performance status being noted in 25% of subjects. Both regimens were well tolerated. These data show that the administration of cisplatin-based secondline chemotherapy to patients with symptomatic advanced NSCLC may be useful.     

A randomized trial in inoperable non-small-cell lung cancer: vindesine and cisplatin versus mitomycin, vindesine, and cisplatin versus etoposide and cisplatin alternating with vindesine and mitomycin.

Patients with inoperable non-small-cell lung cancer (NSCLC) were randomly assigned to receive one of three dosage regimens: (1) vindesine and cisplatin (VP); (2) mitomycin, vindesine, and cisplatin (MVP); or (3) etoposide and cisplatin alternating with vindesine and mitomycin (EP/VM). In 199 assessable patients, the response rates were VP, 33%; MVP, 43%; and EP/VM, 19%. The addition of mitomycin to the VP regimen did not significantly improve the response rate. The response rate was significantly lower with the EP/VM regimen than with the MVP regimen (P less than .01). The median survival times were VP, 50 weeks; MVP, 42 weeks; and EP/VM, 40 weeks. These differences were not significant. Grade III or IV thrombocytopenia was significantly greater (P less than .01) in MVP patients (22%) than in the VP (5%). Other toxicities were similar in the three groups. Analyses of prognostic factors showed that treatment with MVP, sex, and histologic classification (squamous cell carcinoma) were predictive of improved response. Important factors for improved survival, according to the Cox regression analysis, were the stage of disease, performance status, sex, weight loss before diagnosis, and hemoglobin concentration.     

MNP和MVP方案治疗非小细胞肺癌的临床研究

目的　比较MNP和MVP方案治疗晚期非小细胞肺癌 (NSCLC)的疗效和不良反应。方法　 12 6例晚期NSCLC患者随机分为A和B组 ,A组采用MNP(丝裂霉素 去甲长春花碱 顺铂 )方案化疗。B组采用MVP(丝裂霉素 长春酰胺 顺铂 )方案化疗。至少连用 2个周期后评价疗效。结果　A组有效率为 5 4.0 % ( 3 4/63 ) ,B组有效率为 3 4.9% ( 2 2 /63 ) ,无显著性差异 (P>0 .0 5 ) ;其中对腺癌有效率A组为 44 .4% ( 16/3 6) ,B组为 3 3 .3 % ( 12 /3 6)。A组静脉炎发生率为 2 8.6% ( 14 /4 9) ,B组为 0 (P <0 .0 5 ) ,其它不良反应 2组无显著性差异。结论　MNP方案为治疗晚期NSCLC较为有效和安全的化疗方案     

NP和MVP方案治疗非小细胞肺癌的初步比较

目的]初步比较NP和MVP方案对晚期非小细胞肺癌(NSCLC)的疗效和不良反应。[方法]45例Ⅲ期或Ⅳ期NSCLC患者随机分为A组和B组 ,A组应用NP(去甲长春花碱 顺铂)方案化疗 ,B组应用MVP(丝裂霉素 长春花碱酰胺 顺铂)方案化疗 ,至少连用2周期后评价疗效和不良反应。[结果]两组均无完全缓解病例 ,A组有效率为45 5 %(10/22) ,B组35 0 %(7/20) ,差异无显著性(P>0 05)。其中对腺癌有效率A组为53 3 %(8/15) ,B组为35 7%(4/14)。A组静脉炎发生率为27 3 %(6/22) ,B组为0(P<0 05) ;其它不良反应两组均相似。[结论]NP方案为治疗晚期NSCLC较为有效和安全的化疗方案。     

Mitomycin C plus vindesine plus etoposide (MEV) versus mitomycin C plus vindesine plus cisplatin (MVP) in stage IV non-small-cell lung cancer: A phase III multicentre randomised trial

PURPOSE:: To compare mitomycin C plus vindesine plus etoposide (MEV) vs.mitomycin C plus vindesine plus cisplatin (MVP) in the treatmentof stage IV non-small-cell lung cancer. PATIENTS AND METHODS:: 204 patients were entered in a phase III multicentre randomisedtrial from June 1990 to December 1994 and stratified accordingto the ECOG performance status (0–1 vs. 2). MVP was givenin the following dosages: mitomycin C 8 mg/m² + vindesine 3mg/m² + cisplatin 100 mg/m² i.v. day 1 and vindesine 3 mg/m²i.v. day 8 with cycles repeated every 4 weeks. MEV was givenin the following dosages: mitomycin C 8 mg/m² + vindesine 3mg/m² i.v. day 1 and etoposide 100 mg/m² i.v. days 1 to 3 withcycles repeated every 3 weeks. For both treatments a maximumof 6 cycles was planned. Response and toxicity were evaluatedaccording to WHO. Subjective responses were assessed by numericalscales. Analyses were made on the basis of intent to treat. RESULTS:: The objective response rate was 21.4% (1 CR + 21 PR among 103patients) in the MEV and 28.7% (1 CR + 28 PR among 101 patients)in the MVP arm (P=0.48). Symptoms were similar in the two arms.196 patients progressed and 182 died. The median times to progressionwere 10 weeks (95% CI 9–12) and 12 weeks (95% CI 10–15)and median survivals were 29 weeks (95% CI 25–36) and28 weeks (95% CI 25–35) in the MEV and MVP arms, respectively.The relative risks of progressing and of dying were 0.89 (95%CL 0.66–1.20) and 0.96 CL 0.71–1.30), respectively,for patients receiving MVP as compared with those receivingMEV at multivariate analysis adjusted by sex, age, histologictype, number of metastatic sites, performance status at entry,and centre. CONCLUSIONS:: In the present study, no significant dfferences were observedin response rate, survival or palliation of symptoms betweenthe MEV and MVP regimens, while toxicity was significantly morefrequent and severe with MVP. Thus, MEV should be considereda reasonable alternative to the MVP regimen in the treatmentof stage IV NSCLC. chemotherapy, non-cisplatin-containing, regimen, stage IV NSCLC     

A phase III randomized trial comparing vindesine and cisplatin with or without ifosfamide in patients with advanced non-small-cell lung cancer: long-term follow-up results and analysis of prognostic factors

In order to evaluate the activity and toxicity of a three-drug combination of vindesine, ifosfamide and cisplatin (VIP) for inoperable non-small-cell lung cancer (NSCLC), we conducted a randomized trial comparing VIP with a two-drug combination of cisplatin and vindesine (VP). Between September 1987 and March 1992, a total of 132 patients with stage III or IV NSCLC were randomly allocated to either VIP or VP. The VIP regimen consisted of vindesine (VDS 3 mg/m(2) on days 1 and 8), ifosfamide (IFX 1300 mg/m(2) on days 1-5), and cisplatin (CDDP 20 mg/m(2) on days 1-5). The VP regimen consisted of VDS and CDDP with the same dose and schedule as the VIP regimen. Both regimens were repeated every 4 weeks. Objective response rates were 49.3% (95% confidence interval: 95%CI, 43.1-55.4%) in the VIP arm and 44.6% (95%CI, 38.4-50.2%) in the VP arm; the difference was not significant (P=0.5390). Median response duration, median survival time, and two-year survival rates were 26.5 weeks, 49.6 weeks, and 14.9% in the VIP arm and 28.7 weeks, 37.1 weeks, and 12.3% in the VP arm, respectively. There were also no significant differences between these two treatment arms. In comparison with the VP regimen, however, a survival advantage of the VIP regimen could be confirmed when the data were evaluated with Cox's multivariate analysis (P=0.0131). In both arms, the principal toxicity was myelosuppression, which was significantly more frequent in the VIP arm, although generally well tolerated. CONCLUSION: This study suggested the survival advantage of the VIP regimen over the VP regimen for treatment of patients with advanced NSCLC.     

Induction chemotherapy with mitomycin, vindesine, and cisplatin for stage III unresectable non-small-cell lung cancer: results of the Toronto Phase II Trial.

PURPOSE: The 5-year survival rates with surgical resection for preoperatively identified stage IIIA N2 non-small-cell lung cancer (NSCLC) are less than 10%. A pilot study of mitomycin, vindesine, and cisplatin (MVP) induction chemotherapy was undertaken in an attempt to improve the curative potential of surgery in this group of patients. PATIENTS AND METHODS: Thirty-nine patients with mediastinoscopy stage IIIA N2 NSCLC received two cycles of MVP. Responding patients underwent thoracotomy for resection and two further courses of MVP. RESULTS: The overall response rate was 64% (25 of 39) with three complete and 22 partial responses. Twenty-two patients were resected, which included a radical mediastinal node dissection. Eighteen resections were complete and four were incomplete. Pathologically, three patients (7.7%) had no tumor remaining. Toxicity included two postoperative deaths secondary to a bronchopleural (BP) fistula, mitomycin pulmonary toxicity in two patients, and septic deaths in four patients. Twenty-eight patients have died; 20 have recurrent or progressive disease. Eight of the 18 patients completely resected have recurred, with a median time to recurrence of 20.6 months. Sites of recurrence include two locoregional, five distant (two in brain), and one in both. Median survival of all 39 patients is 18.6 months, with a 3-year survival of 26%. The median survival for those patients completely resected was 29.7 months with a 3-year survival of 40%. CONCLUSIONS: We conclude (1) that MVP is an effective but toxic chemotherapeutic regimen for limited NSCLC; (2) the median survival seems to be prolonged; and (3) the role of induction chemotherapy followed by surgery in stage IIIA N2 NSCLC requires a phase III randomized trial to compare it with other treatment modalities.     

Mitomycin C, vindesine, and cisplatin in advanced non-small-cell lung cancer. A phase II study.

Between August 1985 and June 1986, 49 previously untreated patients with locally advanced or metastatic non-small-cell lung cancer (NSCLC) were treated with the combination of cisplatin 80 mg/m2 i.v. on day 1, vindesine 3 mg/m2 i.v. on days 1 and 8, and mitomycin-C 8 mg/m2 i.v. on day 1 (MVP), repeating after an interval of 4 weeks, and thereafter every 6 weeks. The median age for all patients was 62 years, with a range of 21 to 77 years. All patients had a performance status of 0, 1, or 2 (ECOG scale) and measurable disease. Histologic types included squamous cell carcinoma (22 patients), adenocarcinoma (22 patients), and large-cell carcinoma (6 patients). Forty-eight patients were evaluable for response. Out of 48 patients, one (2%) achieved a complete response and 24 patients (50%) achieved a partial response, resulting in an overall response rate of 52% (95% confidence interval, 38-68%). The response rates were 52% for squamous cell carcinoma, 45% for adenocarcinoma, and 80% for large-cell carcinoma, respectively. The median duration of response was 4.2 months and the median duration of survival for all patients was 10.6 months. The major toxicity was myelosuppression. Leukopenia and thrombocytopenia of grade 3 or 4 occurred in 85% and 33%, respectively. One patient died of sepsis associated with leukopenia. Other toxicities were manageable and reversible. In conclusion, the MVP regimen was active and tolerable in patients with advanced NSCLC. Prospective randomized study comparing the MVP regimen with the two-drug combination of vindesine and cisplatin is warranted.     

Random prospective study of vindesine versus vindesine plus high-dose cisplatin versus vindesine plus cisplatin plus mitomycin C in advanced non-small-cell lung cancer

In this phase III randomized study, 124 evaluable patients with unresectable non-small-cell lung cancer (NSCLC) were randomized to vindesine v cisplatin (120 mg/m2) plus vindesine v cisplatin (60 mg/m2) plus vindesine plus mitomycin C. The objective response rate for cisplatin and vindesine was 27% v 20% for cisplatin, vindesine, and mitomycin C, and 14% for vindesine alone (P = .25 for cisplatin and vindesine v vindesine). The percentage of patients having stable disease (no progression for a minimum of 3 months) was 20% (cisplatin and vindesine), 27% (cisplatin, vindesine, and mitomycin C), and 26% (vindesine alone), respectively. The median survival time for vindesine was 18 weeks, compared with 26 weeks for cisplatin and vindesine and 17 weeks for cisplatin, vindesine, and mitomycin C. Overall survival was not statistically different for cisplatin plus vindesine v vindesine (P = .65). There was no evidence for improved duration of remission or survival of responders with the cisplatin (120 mg/m2) and vindesine arm. This study failed to demonstrate sufficient therapeutic benefit for cisplatin and vindesine (+/- mitomycin C) compared with single-agent vindesine to justify the increased cost and toxicity of these combination regimens.