Ramm K, Vergote I B, Kaern J, Tropé C G
Department of Gynecologic Oncology, Norwegian Radium Hospital, Montebello, Oslo.
Gynecol Oncol. 1992 Aug;46(2):203-7. doi: 10.1016/0090-8258(92)90256-i.
The response rate and survival obtained with the combined regimen of bleomycin, ifosfamide, and cis-platinum (BIP) were analyzed in a series of 24 patients with recurrent cervical carcinoma in previously irradiated area. The doses were 30 mg, 5000 mg/m2, and 50 mg/m2, respectively. Mesna was given simultaneously (6000 mg/m2). None of the patients were treated with prior chemotherapy. All the patients were evaluable for toxicity and 20 for response. The median survival in patients evaluable for response was 9 months. No complete and 3 partial responses (15%) were observed, with a median duration of survival of 10+ months (range, 9(+) -16). Stable disease was observed in 8 patients (40%) with a median duration of survival of 9.5 months (range, 6(+) -20). Progressive disease was observed in 9 patients (45%) with a median duration of survival of 6 months (range, 3-25+). Four patients received one course only because of toxicity. One of these patients died at home 6 days after the first course, probably because of dehydration. The main toxicities were myelosuppression, renal impairment, alopecia, and nausea/vomiting. In conclusion, the BIP regimen has considerable toxicity. We were not able to confirm the high response rates earlier reported in pelvic recurrence inside a previously irradiated area. Emphasis in future studies must continue to be placed on the development of more active single agents and combinations.
对24例先前接受过放疗的复发性宫颈癌患者采用博来霉素、异环磷酰胺和顺铂联合方案（BIP）进行治疗，分析其缓解率和生存率。剂量分别为30mg、5000mg/m²和50mg/m²。同时给予美司钠（6000mg/m²）。所有患者均未接受过先前的化疗。所有患者均可评估毒性，20例可评估疗效。可评估疗效患者的中位生存期为9个月。未观察到完全缓解，3例部分缓解（15%），中位生存期为10+个月（范围9(+) - 16）。8例患者（40%）病情稳定，中位生存期为9.5个月（范围6(+) - 20）。9例患者（45%）病情进展，中位生存期为6个月（范围3 - 25+）。4例患者因毒性仅接受了一个疗程的治疗。其中1例患者在第一个疗程后6天在家中死亡，可能是由于脱水。主要毒性反应为骨髓抑制、肾功能损害、脱发和恶心/呕吐。总之，BIP方案毒性较大。我们未能证实先前报道的在先前放疗区域内盆腔复发的高缓解率。未来研究必须继续着重于开发更有效的单一药物和联合方案。
