Forty-eight patients with advanced gastric cancer and measurable areas of malignant disease were treated with etoposide (130 mg/m2/day X 3 days) plus cisplatin (45 mg/m2day on days 2 and 3). Both drugs were given by constant intravenous infusion and repeated every 4 weeks. Common toxic reactions included nausea, vomiting, diarrhea, alopecia, peripheral neuropathy, leukopenia, and thrombocytopenia. Most patients experienced severe but reversible toxic reactions. In 46 evaluable patients an overall objective regression rate of 28% was obtained with a median duration of regression of 4 months. Regression rates were only modestly reduced among patients with prior chemotherapy exposure (21%). Whereas this combination of etoposide and cisplatin does not appear to offer any major advantage over other single and combination regimens in the treatment of advanced gastric cancer, it shows definite activity and its lack of cross-resistance with other commonly used agents for this disease could indicate a possible role in new combination or sequential chemotherapy approaches. As an interesting sidelight, we found that 21% of our patients had elevated human chorionic gonadotropin (HCG) levels, and among this group regression rates were higher than in HCG-negative patients. It would be of interest to extend these observations in other gastric carcinoma studies involving cisplatin regimens.

译文

:对48例晚期胃癌和可测量的恶性肿瘤患者进行了依托泊苷(130 mg / m2 /天X 3天)加顺铂(45 mg / m2天在第2天和第3天)的治疗。两种药物均通过持续静脉输注给药,每4周重复一次。常见的毒性反应包括恶心,呕吐,腹泻,脱发,周围神经病,白细胞减少症和血小板减少症。大多数患者经历了严重但可逆的毒性反应。在46位可评估的患者中,总体客观回归率为28%,中位回归时间为4个月。在先前接受过化疗的患者中,回归率仅适度降低(21%)。尽管依托泊苷和顺铂的这种组合在晚期胃癌的治疗中似乎没有比其他单一和组合方案提供任何主要优势,但它显示出一定的活性,并且与该疾病的其他常用药物缺乏交叉耐药性可能表明在新的联合疗法或顺序化疗方法中可能发挥作用。有趣的是,我们发现21%的患者绒毛膜促性腺激素(HCG)水平升高,并且这一组的回归率高于HCG阴性患者。在涉及顺铂方案的其他胃癌研究中扩展这些观察结果将是令人感兴趣的。

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