Cervellino J C, Araujo C E, Pirisi C, Sanchez O, Brosto M, Rossi R
Hospital Prof. Bernardo Houssay, Vicente Lopez, Buenos Aires, Argentina.
Cancer Chemother Pharmacol. 1990;26 Suppl:S1-3. doi: 10.1007/BF00685406.
This study was carried out to assess the efficacy of high-dose ifosfamide/mesna (HDIFM) in the treatment of advanced or recurrent cancer of the cervix. In all, 18/21 evaluable patients with advanced or inoperable cervical cancer were included. The mean age was 42 years (range, 31-58 years); and the International Federation of Gynecology and Obstetrics (FIGO) stage was III in 10 patients and IV in 11. The Karnofsky performance status ranged between 70 and 90, with a median of 77. Ten patients had previously been treated with surgery, radium and cobalt (8) or cobalt alone (2). Therapy consisted of 3.5 g/m2, ifosfamide (IFO) given in an 8-h i.v. infusion on days 1-5 and mesna at 20% of the IFO dose, given i.v. at 0, 2, 4, 6 and 8 h, followed by mesna at 40% of the IFO dose by the oral route at 10 and 12 h on days 1-5. For evaluation purposes, patients received at least two cycles. Toxicity was registered in 137 cycles and was mild to moderate. Three complete (16.6%) and six partial (33.3%) responses were observed (50%), but 66% of them occurred in areas that had not previously been irradiated. The median duration of response was 14 months and the overall median survival was 15+ months (18+ months for responders). The Karnofsky scale after treatment ranged from 90 to 100. The results of this study indicate that HDIFM is well tolerated, giving a high percentage of remission (50%) and significantly improving the quality of life.
本研究旨在评估大剂量异环磷酰胺/美司钠（HDIFM）治疗晚期或复发性宫颈癌的疗效。总共纳入了18/21例可评估的晚期或无法手术的宫颈癌患者。平均年龄为42岁（范围31 - 58岁）；国际妇产科联盟（FIGO）分期为III期的有10例，IV期的有11例。卡诺夫斯基功能状态评分在70至90之间，中位数为77。10例患者先前接受过手术、镭和钴治疗（8例）或仅接受过钴治疗（2例）。治疗方案为异环磷酰胺（IFO）3.5 g/m²，于第1 - 5天静脉滴注8小时，美司钠剂量为IFO剂量的20%，分别在0、2、4、6和8小时静脉注射，随后在第1 - 5天的10和12小时口服美司钠，剂量为IFO剂量的40%。为进行评估，患者至少接受两个周期的治疗。共记录了137个周期的毒性反应，均为轻至中度。观察到3例完全缓解（16.6%）和6例部分缓解（33.3%）（总缓解率50%），但其中66%的缓解发生在先前未接受过放疗的区域。缓解的中位持续时间为14个月，总体中位生存期为15 +个月（缓解者为18 +个月）。治疗后卡诺夫斯基评分范围为90至100。本研究结果表明，HDIFM耐受性良好，缓解率高（50%），并显著改善了生活质量。
