Nishida T, Nagasue N
Department of Obstetrics and Gynecology, National Kokura Hospital, Fukuoka.
Nihon Sanka Fujinka Gakkai Zasshi. 1988 May;40(5):635-9.
Fourteen evaluable patients with gynecologic adenocarcinoma (7 ovarian, 4 endometrial, 2 peritoneal and one breast cancer) were treated with ifosfamide (1 g/m2 X 5 days), adriamycin (50 mg/m2) and cisplatin (50 mg/m2) combined chemotherapy (IAP). All the patients had measurable disease, and three were refractory cases who had received prior chemotherapy including two CAP (cyclophosphamide, adriamycin and cisplatin). To avoid hemorrhagic cystitis induced by ifosfamide, uroprotective mesna (400 mg/body X 3) was used following ifosfamide infusion. The 5-day schedule of IAP treatment brought a 100% response rate in these patients. Complete responses were observed in 3 patients and lasted 6, 10 and 12 months. Partial responses were achieved in 11 patients including two with CAP refractory ovarian cancer, although the remission in previously treated patients was of short duration. Hematologic side effects of the IAP regimen were severe, showing grade 4 leucopenia in 85.7% of the patients, and it required maximal anti-infection treatments. Mesna resulted in microhematuria in only one patient. Despite high age of the patients (mean age: 60.1 years) in this study, CNS (central nervous system) toxicities associated with ifosfamide and mesna treatment were minimal. The results suggested that the IAP combination therapy was effective and acceptable in the control of gynecological adenocarcinomas.
14例可评估的妇科腺癌患者（7例卵巢癌、4例子宫内膜癌、2例腹膜癌和1例乳腺癌）接受了异环磷酰胺（1 g/m²×5天）、阿霉素（50 mg/m²）和顺铂（50 mg/m²）联合化疗（IAP）。所有患者均有可测量的病灶，其中3例为难治性病例，此前接受过包括两种CAP方案（环磷酰胺、阿霉素和顺铂）在内的化疗。为避免异环磷酰胺引起的出血性膀胱炎，在输注异环磷酰胺后使用了尿路保护剂美司钠（400 mg/人×3次）。IAP治疗的5天方案使这些患者的缓解率达到100%。3例患者出现完全缓解，持续时间分别为6个月、10个月和12个月。11例患者获得部分缓解，其中包括2例对CAP方案耐药的卵巢癌患者，不过先前接受过治疗的患者缓解期较短。IAP方案的血液学副作用严重，85.7%的患者出现4级白细胞减少，需要进行最大程度的抗感染治疗。美司钠仅使1例患者出现微血尿。尽管本研究中的患者年龄较大（平均年龄：60.1岁），但与异环磷酰胺和美司钠治疗相关的中枢神经系统毒性极小。结果表明，IAP联合疗法在控制妇科腺癌方面有效且可接受。
