Thatcher N, Anderson H, Smith D B, Steward W P, Webb K, Hilton A, Rahman A
Cancer Chemother Pharmacol. 1986;18 Suppl 2:S30-3. doi: 10.1007/BF00647448.
Ifosfamide at 5 g/m2 was given as a bolus to 48 patients with advanced progressing non-small cell lung cancer. Mesna (5 g/m2) was also given with the ifosfamide, both over 30 min. Further mesna was then given p.o. (3 g/m2) at 4, 8, and 12 h. If oral mesna was not acceptable then one or, if necessary, two 4-h to 6-h infusions (3 g/m2) were administered. A maximum of six courses at 3-weekly intervals was prescribed. A total of 174 courses was administered, and oral mesna was given during 64 courses: discharge was considered possible within 8-10 h after 55% of courses. Haematological toxicity was mild and no renal dysfunction was noted. Two patients became drowsy shortly after ifosfamide, but recovered 24-36 h later. The objective response rate was 29%, with one complete responder. A further 31% of patients (symptomatic responders) with stable disease symptomatically improved after the chemotherapy, by 20 or more points on the Karnofsky scale. The median survival was 5 months for the whole group, and 8 months each for the objective and symptomatic responder groups. Most patients' Karnofsky and respiratory scores improved with the chemotherapy. Ifosfamide with mesna can be given by short infusions, and the mesna given p.o. prevents any urothelial toxicity. Further exploration of short-infusion ifosfamide and mesna therapy would reduce hospitalization and allow for day-case regimens.
以5克/平方米的剂量给48例晚期进展期非小细胞肺癌患者静脉推注异环磷酰胺。同时给予美司钠（5克/平方米），均在30分钟内输完。随后在4小时、8小时和12小时口服美司钠（3克/平方米）。如果患者不能接受口服美司钠，则进行一次（必要时两次）4至6小时的静脉输注（3克/平方米）。规定每3周进行最多六个疗程的治疗。共进行了174个疗程的治疗，其中64个疗程给予了口服美司钠：55%的疗程后8至10小时内可考虑出院。血液学毒性较轻，未观察到肾功能障碍。两名患者在使用异环磷酰胺后不久出现嗜睡，但在24至36小时后恢复。客观缓解率为29%，有一名完全缓解者。另有31%病情稳定的患者（症状缓解者）在化疗后症状改善，卡氏评分提高20分或更多。整个组的中位生存期为5个月，客观缓解组和症状缓解组均为8个月。大多数患者的卡氏评分和呼吸评分在化疗后有所改善。异环磷酰胺联合美司钠可通过短时间输注给药，口服美司钠可预防任何尿路毒性。进一步探索短时间输注异环磷酰胺和美司钠疗法将减少住院时间，并可采用日间治疗方案。
