以表阿霉素为主的化疗方案治疗晚期恶性肿瘤150例报告

Results of epirubicin containing regimens in the management of 150 cases of advanced malignancies

自1963年首次由链丝菌Streptomycespeucetius的培养基中提取到柔红霉素,特别是1968年从其变种S.p.var caesium中分离到阿霉素后,蒽环类抗肿瘤药物受到广泛重视。但很快发现这类药物具有骨髓抑制和心脏毒性。随后,很多学者希望通过改变其结构,从而降低毒性、提高疗效或扩大有效抗瘤谱,目前比较突出的是表阿霉素(Epirubicin,Pharmorubicin,EPI)。表阿霉素与阿霉素的区别是在氨基糖部分4’位的OH基由顺式变成了反式。这种立体结构上的细微变化,使骨髓和心脏的毒性有相当的差异。

A prospective study on a new antibiotic antineoplastic drug Epirubicin (Pharmorubicin,EPI) in the management of advanced malignancies was carried out from January 1985 to March 1989. The total response rate was 60.0%, while 33 cases (22.0% ) with complete remission, 57 (38.0%) partial remission, 33 (22.0%) stable disease and 27 (18.0%) progression after at least 2 cycles of treatment. The response rate was 90.0% for Hodgkin's disease, 80.0% for the intermediate and high grade non-Hodgkin's lymphoma and 51.1% for esophageal cancer. The EPI containing regimens were also effective in the patients with small and non-small lung cancer, breast cancer, gastro- intestinal cancer, urinary tract cancer and nasopharyngeal cancer. The main side effects of EPI containing regimens were also analysed, and the dose-limiting toxicity was still bone marrow depression. Only 5 patients showed mild tachycardia and no one developed chronic heart failure. The role of EPI in chemotherapy of common malignancies was discussed.