Becher R, Höfeler H, Kloke O, Kurschel E, Schilcher R B, Weinhardt O, Wandl U, Schmidt C G
Department of Internal Medicine, West German Tumor Center, Essen.
Semin Oncol. 1989 Feb;16(1 Suppl 3):56-9.
Thirty-five patients with a median age of 55 years (range, 28 to 68 years) and a median Karnofsky status of 80% (range, 40% to 100%) were treated with ifosfamide (1.5 g/m2 plus mesna), methotrexate (40 mg/m2), and 5-fluorouracil (600 mg/m2) intravenously (IV) days 1 and 8 at intervals of 4 weeks. Thirty-four patients had received previous chemotherapy, including anthracyclines in 28 patients. All patients were evaluable for response. A partial remission was achieved in six patients (17%), stable disease in 13 patients (37%), and 16 patients (46%) were unresponsive. Median time to progression was 7 months (range, 4 to 13 months) for partial responders, and 4 months for patients with stable disease. Median survival was 9 months for all patients, 13 months for partial responders, 16 months for no change, and 3 months for progressive disease. Toxicity was tolerable, with myelotoxicity being a dose-limiting factor, mainly in heavily pretreated patients. No treatment-related death occurred. In conclusion, this combination is effective and well tolerated. Ifosfamide is suggested for further evaluation in advanced breast cancer.
35例患者接受了异环磷酰胺（1.5 g/m²加美司钠）、甲氨蝶呤（40 mg/m²）和5-氟尿嘧啶（600 mg/m²）静脉注射治疗，给药时间为第1天和第8天，每4周为一个周期。患者中位年龄55岁（范围28至68岁），中位卡氏评分80%（范围40%至100%）。34例患者曾接受过化疗，其中28例患者接受过蒽环类药物治疗。所有患者均对反应进行了评估。6例患者（17%）获得部分缓解，13例患者（37%）病情稳定，16例患者（46%）无反应。部分缓解患者的中位疾病进展时间为7个月（范围4至13个月），病情稳定患者为4个月。所有患者的中位生存期为9个月，部分缓解患者为13个月，病情无变化患者为16个月，疾病进展患者为3个月。毒性反应可耐受，骨髓毒性是剂量限制因素，主要见于预处理较重的患者。未发生与治疗相关的死亡。总之，该联合方案有效且耐受性良好。建议对异环磷酰胺在晚期乳腺癌中的应用进行进一步评估。
