Maintenance chemotherapy (MC) defines the administration of prolonged relatively low-intensity chemotherapy with the aim of “maintaining” tumor complete remission. This paper aims to report an update of the RMS2005 trial, which demonstrated better survival for patients with high-risk localized rhabdomyosarcoma (RMS) when MC with vinorelbine and low-dose cyclophosphamide was added to standard chemotherapy, and to discuss the published experience on MC in RMS. In the RMS2005 study, the outcome for patients receiving MC vs. those who stopped the treatment remains superior, with a 5-year disease-free survival of 78.1% vs. 70.1% (p= 0.056) and overall survival of 85.0% vs. 72.4% (p= 0.008), respectively. We found seven papers describing MC in RMS, but only one randomized trial that did not demonstrate any advantage when MC with eight courses of trofosfamide/idarubicine alternating with trofosfamide/etoposide has been employed in high-risk RMS. The use of MC showed better results in comparison to high-dose chemotherapy in non-randomized studies, including metastatic patients, and demonstrated feasibility and tolerability in relapsed RMS. Many aspects of MC in RMS need to be investigated, including the best drug combination and the optimal duration. The ongoing EpSSG trial will try to answer some of these questions.
维持化疗（MC）指通过给予相对低强度、长期持续的化疗，以“维持”肿瘤完全缓解状态。本文旨在报告RMS2005试验的最新进展（该试验证明在高危局限性横纹肌肉瘤患者的标准化疗基础上，联合使用长春瑞滨与小剂量环磷酰胺进行维持化疗可改善患者生存），并综述已发表的关于横纹肌肉瘤维持化疗的研究经验。在RMS2005研究中，接受维持化疗的患者相较于停止治疗的患者仍显示出更优的疗效：5年无病生存率分别为78.1%对比70.1%（p=0.056），总生存率分别为85.0%对比72.4%（p=0.008）。我们共发现七篇关于横纹肌肉瘤维持化疗的文献，但仅有一项随机试验显示，在高危横纹肌肉瘤患者中使用曲磷酰胺/伊达比星与曲磷酰胺/依托泊苷交替进行八个疗程的维持化疗未带来任何获益。在非随机研究中（包括转移性患者），维持化疗相较于高剂量化疗显示出更好的疗效，并在复发性横纹肌肉瘤中证实了其可行性与耐受性。横纹肌肉瘤维持化疗的诸多方面仍需深入研究，包括最佳药物组合与治疗时长。正在进行的EpSSG试验将尝试解答其中部分问题。
肿瘤(癌症)患者之家