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应用大剂量化疗和自体骨髓移植(ABMT)治疗恶性肿瘤其疗效取决于多种化疗药物的协同作用,但受到非血液学副作用(如充血性心衰,急性肾衰等)的限制,联合不同作用机制和毒性不重迭的化疗药物,可克服肿瘤细胞的异质性和抗药性。卡铂是第二代铂类化疗药,它广泛用于ABMT的预处理方案,尤其是联合环磷酰胺和足叶乙甙(VP16)。为了确定这联合方案的最大耐受剂量(MTD),作者应用大剂量卡铂、VP16和环磷酰胺作为ABMT中的预处理方案,并采用剂量递增法,对34例晚期恶性肿瘤进行研究。 病人和方法 1989～1990年34例经组织学确诊
The efficacy of high-dose chemotherapy and autologous bone marrow transplantation (ABMT) for the treatment of malignant tumors depends on the synergistic action of various chemotherapy drugs, but is limited by non-hematological side effects (such as congestive heart failure, acute renal failure, etc.), combined with different effects. Mechanisms and toxicities that do not overlap in chemotherapeutic drugs can overcome tumor cell heterogeneity and drug resistance. Carboplatin is a second-generation platinum-based chemotherapeutic agent that is widely used in the ABMT pretreatment regimen, especially in combination with cyclophosphamide and acetochlor (VP16). To determine the maximum tolerated dose (MTD) of this combination regimen, the authors used large doses of carboplatin, VP16, and cyclophosphamide as preconditioning regimens in ABMT, and used dose escalation to study 34 cases of advanced malignancies. Patients and Methods 34 cases confirmed by histology from 1989 to 1990