High-dose chemotherapy often requires hematopoietic progenitor cell reinfusion, but drugs with extramedullary dose-limiting toxicity may be administered in the high-dose range by simple growth factor support. In this study, we evaluated the feasibility and toxicity of a three-drug high-dose regimen supported by recombinant human granulocyte colony-stimulating factor (rhG-CSF). Ten patients with histologically proven malignancy were enrolled. Eight had breast cancer, one non-Hodgkin's lymphoma, and one a mediastinal tumor of unknown origin. The regimen included cyclophosphamide (C) 5 g/m2, etoposide (E) 1.5 g/m2, and cisplatin (P) 150 mg/m2 (CEP), administered in a 3-day schedule followed by rhG-CSF, 300 micrograms once a day, beginning from day +5 (36 h after the end of chemotherapy). The cycle was repeated as clinically needed up to three times. After the first course, hematologic recovery was rapid and complete without documented infections, and no relevant extramyeloid toxicities were observed. Eight of 10 patients received a second course with comparably low toxicity, and three of them received a third course. We concluded that CEP therapy can be administered safely and even repeatedly, by simple growth factor support, in good performance status cancer patients.

译文

大剂量化学疗法通常需要重新注入造血祖细胞,但是可以通过简单的生长因子支持在大剂量范围内使用具有髓外剂量限制性毒性的药物。在这项研究中,我们评估了重组人粒细胞集落刺激因子(rhG-CSF)支持的三药大剂量方案的可行性和毒性。十名经组织学证实为恶性肿瘤的患者入选。 8例患有乳腺癌,1例非霍奇金淋巴瘤,1例起源不明的纵隔肿瘤。该方案包括环磷酰胺(C)5 g / m2,依托泊苷(E)1.5 g / m2和顺铂(P)150 mg / m2(CEP),分3天给药,随后用rhG-CSF给药,每次300微克从第5天(化疗结束后36小时)开始的一天。根据临床需要重复该循环多达三次。第一次疗程结束后,血液学恢复迅速且完全,没有记录的感染,也未观察到相关的髓外毒性。 10名患者中有8名接受了第二疗程,毒性较低,其中三名接受了第三疗程。我们得出的结论是,通过简单的生长因子支持,可以对处于良好状态的癌症患者安全,甚至重复使用CEP治疗。

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