Li X, Liu L, Wu L
Cancer Institute (Hospital), Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100021, China.
Zhonghua Zhong Liu Za Zhi. 2000 Jul;22(4):330-2.
To evaluate the clinical efficacy and toxicity of ifosfamide (IFO) combination chemotherapy in patients with advanced gynecologic malignancies.
Thirty-four patients with gynecologic malignancies were included in this series. Of the 34 patients, 26 with epithelial cancer of the ovary were previously treated with cisplatin-containing combination chemotherapy but failed to respond or recurred after treatment. They were treated with IEP (IFO, VP16, PDD) regimen. The remaining 8 patients with uterine sarcoma (5 cases), squamous-cell carcinoma of the uterine cervix with metastases to the liver or bone (2 cases), and endometrial carcinoma with lung metastases (1 case) were treated with IFO combination chemotherapy. At least two courses of treatment were given unless tumor progression occurred after the first course.
The overall response rate was 35.3% including 8.8% complete response. The response rate of 26 patients with ovarian cancer was 30.8%. Two patients with PDD-sensitive tumor all achieved complete response, which lasted for one year. The response rate of the remaining 24 PDD-resistant patients was 25% with a mean duration of 5.5 months. There was no complete response. Two patients with cervical carcinoma and two of five patients with uterine sarcoma responded to IFO combination chemotherapy. Relatively severe hematological toxicity was observed, including grade III and IV leucopoenia and thrombocytopenia. Two patients died from severe toxicity.
IFO combination chemotherapy is effective in treating recurrent or progressive gynecologic malignancies, especially PDD-sensitive ones. Myelosuppression is relatively severe which may be due to prior long term and intensive chemotherapy.
评估异环磷酰胺（IFO）联合化疗治疗晚期妇科恶性肿瘤患者的临床疗效及毒性。
本研究纳入34例妇科恶性肿瘤患者。其中26例卵巢上皮癌患者先前接受含顺铂的联合化疗，但治疗后无效或复发，采用IEP（IFO、VP16、PDD）方案治疗。其余8例子宫肉瘤患者（5例）、宫颈鳞状细胞癌伴肝或骨转移患者（2例）和子宫内膜癌伴肺转移患者（1例）接受IFO联合化疗。除非在第一个疗程后出现肿瘤进展，否则至少给予两个疗程的治疗。
总缓解率为35.3%，其中完全缓解率为8.8%。26例卵巢癌患者的缓解率为30.8%。2例对PDD敏感的肿瘤患者均达到完全缓解，持续1年。其余24例对PDD耐药的患者缓解率为25%，平均持续时间为5.5个月，无完全缓解。2例宫颈癌患者和5例子宫肉瘤患者中的2例对IFO联合化疗有反应。观察到相对严重的血液学毒性，包括III级和IV级白细胞减少和血小板减少。2例患者死于严重毒性。
IFO联合化疗对复发性或进展性妇科恶性肿瘤有效，尤其是对PDD敏感的肿瘤。骨髓抑制相对严重，这可能是由于先前长期强化化疗所致。
