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目的:评价MAID方案一线治疗转移性STS的临床疗效、不良反应和对生存期的影响。方法:根治术后出现远处转移的晚期STS患者137例,阿霉素(ADM)60mg/m~2第1天静脉滴注,异环磷酰胺(IFO)8～10g/m~2分4～5天静脉滴注,IFO开始静脉滴注的0、4、8h各予美司纳(Mesna)每天总量的20%静脉推注,氮烯咪胺(DTIC)200mg/m~2静脉滴注,连续4～5天。21天为1个周期,完成2～6个周期,中位周期数为4个。结果:全组患者CR 4例(2.9%),PR 13例(9.5%),SD 88例(64.2%),PD 32例(23.4%),有效率12.4%,临床获益率76.6%。PFS 2～14个月,mPFS(5.00±1.12)个月,OS 3～19个月,mOS(8.00±1.32)个月。3个月PFS生存率56.9%,6个月PFS生存率27.2%,1年PFS生存率7.8%。3个月OS生存率100.0%,6个月OS生存率41.5%,1年OS生存率10.7%。主要不良反应为骨髓抑制、胃肠道反应和脱发,其他不良反应少见。结论:MAID方案一线治疗转移性STS疗效确切,能够有效控制疾病进展,不良反应可以耐受,作为进展期STS的一线化疗方案具有明显的临床应用价值。
OBJECTIVE: To evaluate the clinical efficacy, side effects and survival of MAID regimen in first-line treatment of metastatic STS. Methods: Thirty-seven patients with advanced STS who had distant metastasis after radical operation were enrolled in this study. Adriamycin (ADM) 60 mg / m ~ 2 was intravenously dripped on the first day, IFO was 8 ~ 10g / ~ 5 days intravenous infusion, IFO began intravenous infusion of 0,4,8 h each to the total daily dose of Mesna 20% intravenous injection, daclizumab (DTIC) 200mg / m ~ 2 intravenous drip Note, for 4 to 5 days in a row. 21 days for a period, completed 2 to 6 cycles, the median number of cycles is 4. Results: All patients were CR 4 (2.9%), PR 13 (9.5%), SD 88 (64.2%) and PD 32 (23.4%). The effective rate was 12.4% and the clinical benefit rate was 76.6%. PFS ranged from 2 to 14 months, mPFS (5.00 ± 1.12) months, OS 3 to 19 months, mOS (8.00 ± 1.32) months. The 3-month PFS survival rate was 56.9%, 6-month PFS survival rate was 27.2%, and 1-year PFS survival rate was 7.8%. The 3-month OS survival rate was 100.0%, the 6-month OS survival rate was 41.5%, and the 1-year OS survival rate was 10.7%. The main adverse reactions were myelosuppression, gastrointestinal reactions and hair loss, with few other adverse reactions. Conclusion: The first-line treatment of metastatic STS with MAID regimen is effective and can effectively control the progression of the disease. The adverse reactions can be tolerated. As the first-line chemotherapy regimen of advanced STS, it has obvious clinical value.