Epirubicin is not Superior to Doxorubicin in the Treatment of AdvancedSoft Tissue Sarcomas.The Experience of the EORTC Soft Tissue andBone Sarcoma Group

[摘要] Purpose.Doxorubicin (dox) still appears to be one of the most activedrugs in the treatment of soft tissue sarcomas. However, treatment duration is limited due tocumulative cardiotoxicity. A number of small studies from single institutions have suggestedactivity of other analogues. In two studies the EORTC STBSG tested whether epirubicin (epi)is an alternative to standard dose dox in the treatment of chemonaive patients with advancedsoft tissue sarcoma. The present report gives the final results of these studies.Patients/Methods.In the first study 210 patients were randomized toreceive either dox or epi both at a dose of 75 mg/m2given as bolus injection at 3-weekintervals. In the second study 334 patients were randomized to dox 75 mg/m2,epi 150 mg/m2or epi 50 mg/m2days 1–3, all given as bolus injection at 3-week intervals.Results.In the first study no differences in median survival and durationof response were found. Of 167 evaluable patients the response rate was slightly in favour ofdox (23% vs 18%) but at the expense of more toxicity.These data could suggest that increasingthe epi dose may lead to a greater antineoplastic effect with acceptable toxicity. In the secondstudy 15% of 314 evaluable patients had an objective tumour response.There were no differences between the three groups with regard to response rate,progression-free and overall survival, but both dose schedules of epi were more myelotoxicthan dox.Conclusion.Regardless of schedule and dose, epi is not superior to doxin the treatment of patients with advanced soft tissue sarcomas. In addition, the resultsillustrate that the data from small studies of single institutions should always be confirmedby large multi-institutional studies before being taken for granted.

[学科分类] 肿瘤学