目的:关于腹膜后软组织肉瘤的全身治疗的证据有限,而目前的日本指导方针未能提出明确的建议。这里,我们报告了我们的Mesna联合化疗的经验,阿霉素,异环磷酰胺,和达卡巴嗪(MAID)在该人群中。
方法:我们回顾性回顾了8例患者(3例男性和5例女性)的记录,这些患者在2019年10月至2022年1月期间因病理诊断为转移性不可切除的腹膜后肉瘤(平滑肌肉瘤或多形性肉瘤)而接受MAID。治疗效果,耐受性(需要减少剂量),和安全性概况进行评估和总结.
结果:开始时,中位年龄为56.0岁,体重指数为20.0kg/cm26例患者的东部肿瘤协作组表现状态评分为0。净临床获益是三名(37.5%)患者的部分反应,4例疾病稳定(50.0%),和进行性疾病之一(12.5%)。在中位90.8周的随访期间,五名患者的病情进展,导致中位无进展生存期为48.4周,发生了5人死亡,导致95.1周的总生存期。常见的不良事件是中性粒细胞减少症(8例),贫血(8名患者),血小板计数下降(7名患者),这导致6名患者的剂量减少(60-80%)。
结论:MAID联合治疗可能是晚期腹膜后肉瘤的可接受选择;然而,由于其毒性并非微不足道,因此必须仔细评估其益处。
OBJECTIVE: There is limited evidence regarding the systemic treatment of retroperitoneal soft-tissue sarcoma, and the current Japanese guidelines fail to make definitive suggestions. Here, we report our experience with combination chemotherapy of mesna, doxorubicin,
ifosfamide, and dacarbazine (MAID) in this population.
METHODS: We retrospectively reviewed the records of eight patients (three male and five female) who received MAID for pathologically diagnosed metastatic unresectable retroperitoneal sarcoma (either leiomyosarcoma or pleomorphic sarcoma) between October 2019 and January 2022. Treatment efficacy, tolerability (need for dose reduction), and safety profiles were evaluated and summarized.
RESULTS: At initiation, the median age was 56.0 years, and the body mass index was 20.0 kg/cm2 Six patients had Eastern Cooperative Oncology Group performance status scores of 0. The net clinical benefit was a partial response in three (37.5%) patients, stable disease in four (50.0%), and progressive disease in one (12.5%). During the median 90.8 weeks of follow-up, disease in five patients progressed, resulting in a median progression-free survival of 48.4 weeks, and five deaths occurred, resulting in an overall survival of 95.1 weeks. Commonly observed adverse events were neutropenia (eight patients), anemia (eight patients), and decreased platelet count (seven patients), which led to dose reduction (60-80%) in six patients.
CONCLUSIONS: MAID combination therapy may be an acceptable option for advanced retroperitoneal sarcoma; however, its benefits must be carefully assessed owing to its not insignificant toxicity.