Sutton G P, Blessing J A, Manetta A, Homesley H, McGuire W
Department of Obstetrics and Gynecology, Indiana University Medical Center, Indianapolis 46202.
Semin Oncol. 1992 Dec;19(6 Suppl 12):31-4.
The Gynecologic Oncology Group has conducted a series of phase II studies with ifosfamide and mesna since 1985. Previously untreated patients received ifosfamide 1.5 g/m2 intravenously daily for 5 days. Mesna was given intravenously every 4 hours three times daily at 20% of the daily ifosfamide dose. Because of the toxic effects observed in previously treated patients with ovarian cancer, the ifosfamide dose was reduced to 1.2 g/m2/d in patients with prior chemotherapy or radiotherapy. In epithelial ovarian cancer, responses were observed in eight (20%) of 41 evaluable patients, with three (7%) complete responses. In patients with squamous carcinoma of the cervix, an 11.1% response rate (three of 27 patients) was observed in those who had received prior platinum therapy. In 51 previously untreated patients, the response rate was 15.7%. In nonsquamous cervical carcinomas, there were three partial responses among 25 patients (12%). An 8.6% response rate was observed among 23 patients with previously treated endometrial adenocarcinomas. In uterine sarcomas, response rates were 30.7% in mixed müllerian tumors, 17.2% in leiomyosarcomas, and 27.3% in endometrial stromal sarcomas. Patients with ovarian sarcomas responded in 27.8% of cases. Studies with ifosfamide combinations are currently under way by the Gynecologic Oncology Group.
自1985年以来，妇科肿瘤研究组开展了一系列关于异环磷酰胺和美司钠的II期研究。既往未经治疗的患者接受异环磷酰胺1.5 g/m²静脉滴注，每日1次，共5天。美司钠按异环磷酰胺每日剂量的20%，每4小时静脉注射1次，每日3次。由于在既往接受过治疗的卵巢癌患者中观察到毒性作用，对于既往接受过化疗或放疗的患者，异环磷酰胺剂量减至1.2 g/m²/日。在上皮性卵巢癌中，41例可评估患者中有8例（20%）出现反应，其中3例（7%）完全缓解。在既往接受过铂类治疗的子宫颈鳞状癌患者中，观察到缓解率为11.1%（27例患者中有3例）。在51例既往未经治疗的患者中，缓解率为15.7%。在非鳞状子宫颈癌中，25例患者中有3例部分缓解（12%）。在23例既往接受过治疗的子宫内膜腺癌患者中，观察到缓解率为8.6%。在子宫肉瘤中，混合性苗勒管肿瘤的缓解率为30.7%，平滑肌肉瘤为17.2%，子宫内膜间质肉瘤为27.3%。卵巢肉瘤患者的缓解率为27.8%。妇科肿瘤研究组目前正在进行异环磷酰胺联合用药的研究。
