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目的 研究长春酰胺、阿克拉霉素、丝裂霉素联合化疗治疗耐药卵巢癌的疗效和毒性反应。 方法 联合应用长春酰胺、阿克拉霉素、丝裂霉素（ＶＡＭ 方案） 治疗２０ 例经铂类化疗失败的卵巢癌（ 均经体检和（ 或） 影像学确诊） 。 结果 总有效率为３５０ ％ （完全缓解２ 例，部分缓解５ 例） ，达到与紫杉醇相似的近期疗效。耐药种数≥５ 种者的有效率为３００％ ，停用铂类化疗时间≤６ 月者的有效率为２００ ％ 。毒性反应以骨髓抑制为明显，Ⅲ＋Ⅳ度白细胞、中性粒细胞和血小板下降分别为４５０％ 、７００％ 和３５０ ％ ，但在小剂量集落刺激因子支持下，未发生严重并发症。胃肠反应、心脏、神经毒性均不严重，脱发占４００％ 。 结论 ＶＡＭ 方案治疗耐铂卵巢癌疗效肯定，与紫杉醇相仿，价格明显低于其他二线化疗药物，是当前国内卵巢癌二线化疗切实可行有效方案，值得推广应用。
Objective To study the efficacy and toxicity of vincristine, aclacinomycin and mitomycin combined with chemotherapy in the treatment of drug-resistant ovarian cancer. Methods 20 patients with ovarian cancer failed by platinum chemotherapy were diagnosed by the combination of vincristine, aclacinomycin and mitomycin C (VAM regimen), both confirmed by physical examination and / or imaging. Results The total effective rate was 350% (complete remission in 2 cases, partial remission in 5 cases), to achieve similar efficacy with paclitaxel in the near future. The effective rate of resistant species≥5 species was 300%, and the effective rate of patients with platinum-resistant chemotherapy less than 6 months was 200%. Toxicity was markedly inhibited by myelosuppression. The leukocyte, neutrophil and thrombocytopenia in stage Ⅲ + Ⅳ were 450%, 700% and 350%, respectively. However, no serious complications occurred with the support of low dose of colony stimulating factor disease. Gastrointestinal reactions, heart, neurotoxicity are not serious, hair loss accounted for 40 0%. Conclusions The efficacy of VAM regimen in the treatment of platinum-resistant ovarian cancer is similar to that of paclitaxel and its price is obviously lower than that of other second-line chemotherapy drugs. It is a feasible and effective regimen for the second-line chemotherapy of ovarian cancer in China and is worth popularizing and applying.