长春花碱酰胺联合化疗治疗非霍奇金淋巴瘤35例临床观察

目的：观察长春花碱酰胺（VDS）组成的联合方案治疗非霍奇金淋巴瘤（NHL）的疗效及毒副反应。方法：35例NHL用以下方案化疗：CTX500mg/m2，iv,第1、8天；ADM30～40mg/m2，iv,第1天；VDS2．5～3mgm2，iv，第1、8天；PDN100mg日，po，第1至5天，21～28天为1周期。全部病例用药均在2周期以上。结果：全组35例，CR9例，PR22例，总有效率88．6％。主要毒副反应有骨髓抑制、恶心、呕吐、脱发等。     

顺铂联合长春地辛治疗晚期乳腺癌22例

（目的）观察低剂量DDP＋VDS为主的联合化疗对晚期乳腺癌的治疗效果。（方法）22例晚期乳腺癌，采用CMVP方案9例，CFW方案5例，CAVP方案8例，一个疗程后评价疗效及毒性反应。（结果）总有效率68．2％。其中CMVP667％，CFVP60．0％，CAVP75．0％。初治有效率66．7％，复治有效率57．9％，两者相比差异无显著性（P＞0．05）。主要毒副反应为胃肠反应、骨髓抑制、脱发、静脉炎；末梢神经炎及肾毒性轻。（结论）以低剂量DDP＋VDS为主的联合化疗方案治疗晚期乳腺癌毒副反应轻、患者易接受、疗效高于以DDP为主或VDS为主的联合化疗，两者联合可作为治疗晚期乳腺癌的一线方案。     

Combination chemotherapy with mitomycin C,vindesine and melphalan for refractory metastatic breast cancer

Summary A combination of mitomycin C, vindesine and melphalan was administered to 33 patients with heavily pretreated refractory breast cancer. The overall response rate was 27% with a mean duration of more than 10.2 months. A stabilization with a mean duration of 5.1 months was seen in 56% of cases, while 20% of patients progressed. Gastrointestinal toxicity, mostly grade 1 or 2 nausea/vomiting was seen in 85% of cases, grade 1 or 2 leukopenia in 60% of patients, and grade 1 or 2 thrombocytopenia in 42%. Considering the good compliance of this regimen and the poor prognosis of patients with refractory advanced breast cancer, this combination can be useful as a palliative treatment of breast carcinoma.Abbreviations MMC mitomycin C - VDS vindesine - L-PAM melphalan     

Combination chemotherapy of advanced medullary and differentiated thyroid cancer

Summary A group of 20 patients with advanced medullary (MTC) or differentiated thyroid carcinoma (DTC) received a combination chemotherapy of doxorubicin (50 mg/m²), cisplatin (60 mg/m²) and vindesine (3 mg/m²). In the 18 (10 MTC, 8 DTC) evaluable patients only 1 partial remission (in a patient with MTC) and 3 minor responses (in 3 patients with DTC) were observed. These responses lasted for 15, 9, 13, and 22 months, respectively. Three MTC patients suffered from progressive disease and no change was seen in the other 11 patients. Toxicity, including 1 severe case of cardiomyopathy, was considerable. Thus, the combination chemotherapy of doxorubicin, cisplatin and vindesine has failed to prove superior to the commonly applied doxorubicin monotherapy in patients with advanced medullary or differentiated thyroid carcinoma.Abbreviations MTC, DTC medullary and differentiated thyroid carcinoma This study was supported by a grant of the German Cancer Research Center (Tumorzentrum Heidelberg/Mannheim)     

长春地辛及含长春地辛方案治疗晚期恶性肿瘤的二期临床研究

使用长春地辛（ＶＤＳ）和长春碱（ＶＬＢ）治疗恶性肿瘤５６例。结果ＶＤＳ单药有效率为２２．７％，ＶＤＳ联合组有效率４２．１％，ＶＬＢ联合组有效率３５．７％，其中ＶＤＳ＋顺铂（ＤＤＰ）治疗非小细胞肺癌有效率达５０％，稍高于国外相同方案的结果，ＶＬＢ＋ＤＤＰ则为３７．５％。ＶＤＳ和ＶＬＢ的主要毒性为骨髓抑制，白细胞下降（Ⅰ＋Ⅱ＋Ⅲ＋Ⅳ）分别为７３．３％和７４．９％，外周神经毒性轻，所有毒性可以耐受。     

Combination of nedaplatin and vindesine for treatment of relapsed or refractory non-small-cell lung cancer

Purpose: A phase II study of nedaplatin and vindesine was conducted to evaluate their efficacy and safety for treatment of relapsed or refractory non-small-cell lung cancer (NSCLC). Methods : Between August 1996 and September 1998, 48 patients who had previously received chemotherapy, thoracic radiotherapy, and/or surgery were enrolled in the study. Patients were required to have an Eastern Cooperative Oncology Group performance status of 0 to 2 and an age between 20 and 79 years. Treatment consisted of nedaplatin (80 mg/m², day 1) and vindesine (3 mg/m², days 1 and 8) every 3 to 4 weeks. Results: Of 48 patients, 7 (14.6%) exhibited an objective response. Four (50%) of eight chemotherapy-naive patients had a partial response. However, of the 40 patients who had received prior chemotherapy, a partial response was observed in only 3 (7.5%). At a median follow-up time of 85.1 weeks, the median survival time was 43.6 weeks (95% confidence interval 34.4–52.7) for patients who had received chemotherapy, with a survival rate of 40% at 1 year. Grade 3 or 4 neutropenia occurred in 43 of 48 patients (90%), and neutropenic fever was observed in 3 of the 43 patients, one of whom died of sepsis. Pharmacokinetic and pharmacodynamic analyses of platinum were performed in 43 patients during the first cycle of chemotherapy. Percent reduction in absolute neutrophil count was correlated not only with the area under the plasma ultrafilterable platinum concentration versus time curve (r=0.41, P=0.007) but also with the duration of ultrafilterable platinum concentration above 1 μg/ml (r=0.41, P=0.007). Patients with progressive disease exhibited a shorter duration of ultrafilterable platinum concentration over 1 μg/ml (P=0.046) than those with other responses. Conclusion: A combination of nedaplatin and vindesine was unsatisfactory as second-line chemotherapy for NSCLC, although the combination was well tolerated. The duration of ultrafilterable platinum concentration above 1 μg/ml was an important pharmacokinetic parameter for predicting both chemotherapy-induced neutropenia and treatment outcome. Received: 4 November 1999 / Accepted: 28 April 2000     

长春酰胺,阿克拉霉素和丝裂霉素联合治疗耐药卵巢癌

目的　研究长春酰胺、阿克拉霉素、丝裂霉素联合化疗治疗耐药卵巢癌的疗效和毒性反应。　方法　联合应用长春酰胺、阿克拉霉素、丝裂霉素（ＶＡＭ 方案） 治疗２０ 例经铂类化疗失败的卵巢癌（ 均经体检和（ 或） 影像学确诊） 。　结果　总有效率为３５０ ％ （完全缓解２ 例,部分缓解５ 例） ,达到与紫杉醇相似的近期疗效。耐药种数≥５ 种者的有效率为３００％ ,停用铂类化疗时间≤６ 月者的有效率为２００ ％ 。毒性反应以骨髓抑制为明显,Ⅲ＋Ⅳ度白细胞、中性粒细胞和血小板下降分别为４５０％ 、７００％ 和３５０ ％ ,但在小剂量集落刺激因子支持下,未发生严重并发症。胃肠反应、心脏、神经毒性均不严重,脱发占４００％ 。　结论　ＶＡＭ 方案治疗耐铂卵巢癌疗效肯定,与紫杉醇相仿,价格明显低于其他二线化疗药物,是当前国内卵巢癌二线化疗切实可行有效方案,值得推广应用。     

Vindesine-induced neuropathy mimicking Guillain-Barré syndrome

A 13-year-old girl with acute lymphoblastic leukaemia, who was being treated with chemotherapy (including vindesine), developed paraplegia without paresthesia, which mimic Guillain-Barré syndrome. Spinal fluid analysis showed a normal protein level, vindesine neuropathy seemed to be the cause of the patient's neurological symptoms. The patient seemed to benefit from human normal immunoglobulin therapy and recovered 4 weeks later.     

A phase II study of vindesine in the treatment of esophageal carcinoma. Japanese Esophageal Oncology Group

A phase II study of Vindesine for esophageal carcinoma was carried out cooperatively by 10 Japanese institutions. Fifty patients were enrolled in the study over a year and ten months. Four patients could not be evaluated because less than 4 weeks had elapsed since their preceding therapy. There were one complete remission and five partial remissions among the 46 remaining patients, a response rate of 13.0%. The patient experiencing the complete remission is still alive more than 24 months after treatment. The main side effects were depilation, anorexia, stomatitis and leukopenia. Thrombocytopenia and elevations of blood urea nitrogen and creatinine were not marked. There was no mortality connected with the administration of Vindesine. It was concluded that Vindesine is useful in the treatment of esophageal carcinoma as a single agent.