MAID方案治疗晚期软组织肉瘤的初步报告

背景和目的：晚期和复发转移软组织肉瘤主要采用以化疗为主的综合治疗方法,但目前尚未有一个标准化疗方案,现阶段以异环磷酰胺（ifosfamide,IFO),阿霉素（Adriamycin,ADM)和氮烯咪胺（dacarbazine,DTIC)为较有效的化疗药物,本研究的目的是评价异环磷酰胺 阿霉素 氮烯咪胺方案,即MAID方案治疗晚期软组织肉瘤的疗效和不良反应。方法：采用MAID（Mesna10g/m^296h持续静脉灌注,ADM60mg/m^2 IFO6g/m^2 DTIC1g/m^272h持续静脉灌注）共治疗软组织肉瘤22例。结果：总有效率为36.4%(8/22)。均为部分缓解（PR）,无完全缓解（CR）,中位缓解期为4.6个月（2-10月）,不良反应主要是骨髓抑制,消化道反应和脱发等,按WHO抗癌药不良反应分度标准,Ⅲ Ⅳ级不良反应比例分别为：白细胞下降63.6%,恶心呕吐27.3%,脱发50.0%。结论：MAID方案治疗晚期软组织肉瘤有一定疗效,但疗效有限,且骨髓抑制等不良反应明显,南非进一步研究和开发新的化疗药物和方案。

Preliminary result of advanced soft tissue sarcoma treated by MAID regimen

BACKGROUND & OBJECTIVES: Chemotherapy combined with other therapeutic modalities is the main option for advanced and metastatic soft tissue sarcoma(STS). So far there is no standard regimen for STS yet. Adrimycin, ifosfamide, and dacarbazine are the most effective agents at present. The purpose of this clinical trial was to evaluate the efficacy and toxicity of MAID regimen (mesna/ifosfamide + Adriamycin + dacarbazine) in the treatment of advanced soft tissue sarcoma. METHODS: Twenty-two patients with advanced STS were treated by MAID(Adriamycin 60 mg/m2, ifosfamide 6,000 mg/m2, and dacarbazine 1,000 mg/m2). These drugs were administered as continuous intravenous infusion for 72 hours while mesna was infused continuously for 96 hours. RESULTS: Partial response rate was 36.4% without complete remission. The duration of response ranged from 2-10 months with median of 4.6 months. Main toxicities were myelosuppression, gastrointestinal toxicity and alopecia. Percentage of leucopenia, nausea/vomiting, and alopecia in WHO grade III and IV were 63.6%, 27.3%, and 50%, respectively. CONCLUSIONS: The response rate of MAID for advanced STS was not satisfactory with evident myelosuppression. Further study on new anti-cancer agents and regimen are needed.