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目的 评价异环磷酰胺、阿霉素、顺铂联合方案治疗术后转移性胃平滑肌肉瘤的疗效、毒副反应。方法 16例患者中 ,男性 12例 ,女性 4例 ;年龄 3 2岁~ 78岁 ,中位年龄 5 8岁 ;均经术后病理细胞学证实。异环磷酰胺13 5mg/m2 ,静脉点滴 ,第 1~ 5天 ;阿霉素、3 0~ 40mg/m2 ,静脉注射 ,第 1天 ;顺铂 10mg ,静脉点滴 ,第 6~ 7天。 2 8天 1周期。结果 16例中CR1例 ( 6.3 % ) ,PR3例 ( 18.8% ) ,总有效率 2 5 % ,中位生存率为 11.5月。本方案剂量限制性毒性为骨髓抑制 10 0 % ,主要为Ⅱ至Ⅲ度 ,分别为 5 0 %、3 1.3 %。心脏节律改变 12 .5 % ,治疗后恢复正常。Ⅰ度脱发5 6.2 % ,Ⅱ度脱发 43 .8%。恶心呕吐为 93 .8% ,Ⅱ、Ⅲ度各占 3 1.3 %、12 .5 % ,Ⅳ度反应 1例 ( 6.3 % )。无明显肝肾功能异常。结论 异环磷酰胺、阿霉素、顺铂联合方案治疗术后转移性胃平滑肌肉瘤疗效较好毒副反应可耐受 ,值得临床进一步推广应用
Objective To evaluate the efficacy and side effects of ifosfamide, doxorubicin and cisplatin in the treatment of postoperative metastatic gastric leiomyosarcoma. Methods 16 cases of patients, 12 males and 4 females; aged 32 to 78 years old, the median age of 58 years; confirmed by postoperative pathological cytology. Ifosfamide 13 5mg / m2, intravenous drip, 1st to 5th days; doxorubicin, 30 ~ 40mg / m2, intravenous injection, the first day; cisplatin 10mg, intravenous drip, 6 to 7 days. 2 8 days 1 cycle. Results Among the 16 cases, CR1 (6.3%), PR3 (18.8%) had a total effective rate of 25% and the median survival rate was 11.5 months. The program dose-limiting toxicity of bone marrow suppression 100%, mainly Ⅱ to Ⅲ degrees, respectively, 50%, 3 1.3%. Cardiac rhythm changes 12.5%, returned to normal after treatment. Ⅰ degree hair loss of 5.22%, Ⅱ degree hair loss of 43.8%. Nausea and vomiting was 93.8%, Ⅱ and Ⅲ degrees accounted for 3 1.3%, 12.5%, Ⅳ degree reaction in 1 case (6.3%). No significant liver and kidney dysfunction. Conclusion Ifosfamide, doxorubicin and cisplatin combined treatment of postoperative metastatic gastric leiomyosarcoma with good side effects can tolerate, it is worth further clinical application