Havemann K, Gropp C, Klapsing J, Viktor N, Holle R, Drings P, Manke H G, Hans K, Schroeder M, Heim M
Cancer Chemother Pharmacol. 1986;18 Suppl 2:S40-4. doi: 10.1007/BF00647450.
Patients with small cell carcinoma of the lung (SCCL) were treated in two multicenter trials with different cytostatic drug regimens including ifosfamide. In the first randomized study, including 306 patients, alternating chemotherapy with VP 16, ifosfamide, vindesine (VPIV), adriamycin, cisplatinum, vincristine (APO), and cyclophosphamide, methotrexate, CCNU (CMCC) was compared against standard treatment with ACO (adriamycin, cyclophosphamide, vincristine). It was shown that the alternating therapy resulted in a higher response rate (88% vs 78%) and a longer median survival time (11 months vs 10 months). Regarding toxicity, VPIV was similar to ACO, whereas APO and CMCC had more side-effects, leading to an increase in the number of drop-outs. In the second randomized study 144 patients were treated either with ifosfamide/VP 16 (IVP) or with cisplatinum/VP 16 (PVP). In the case of no further response, no change, or progression the induction therapy was changed to ACO. Interim analyses show that both regimens have similar therapeutic effects; but higher toxicity was observed in patients treated with cis-platinum/VP 16 than in patients treated with ifosfamide/VP 16. According to the response rate in patients treated with ACO after first-line therapy there was less cross-resistance of IVP than of PVP to ACO.
在两项多中心试验中，采用包括异环磷酰胺在内的不同细胞毒性药物方案，对小细胞肺癌（SCCL）患者进行了治疗。在第一项随机研究中，纳入了306例患者，将交替使用依托泊苷、异环磷酰胺、长春地辛（VPIV）、阿霉素、顺铂、长春新碱（APO）以及环磷酰胺、甲氨蝶呤、洛莫司汀（CMCC）进行化疗，与采用阿霉素、环磷酰胺、长春新碱（ACO）的标准治疗进行比较。结果显示，交替疗法导致更高的缓解率（88%对78%）和更长的中位生存期（11个月对10个月）。关于毒性，VPIV与ACO相似，而APO和CMCC有更多副作用，导致退出人数增加。在第二项随机研究中，144例患者要么接受异环磷酰胺/依托泊苷（IVP）治疗，要么接受顺铂/依托泊苷（PVP）治疗。如果没有进一步缓解、病情无变化或病情进展，诱导治疗则改为ACO。中期分析表明，两种方案具有相似的治疗效果；但观察到接受顺铂/依托泊苷治疗的患者比接受异环磷酰胺/依托泊苷治疗的患者毒性更高。根据一线治疗后接受ACO治疗患者的缓解率，IVP对ACO的交叉耐药性低于PVP。
