Nishida T, Nagasue N, Kishi N, Imaishi K, Tateno N, Matsumura T, Yakushiji M
Department of Obstetrics and Gynecology, National Kokura Hospital, Fukuoka.
Nihon Sanka Fujinka Gakkai Zasshi. 1988 Dec;40(12):1883-8.
Seven patients with uterine endometrial carcinoma received a postoperative combination chemotherapy with ifosfamide (1g/m2) daily for 5 days, and adriamycin (50mg/m2) and cisplatin (50mg/m2) on day 1 (IAP). All except one patient with the disease without myometrial invasion received 5 courses or more of IAP treatment. Of four patients with measurable disease, three achieved complete response (CR) and the other patient obtained partial response (PR), indicating a 100% response rate. In the PR case, the patient had previously been treated by radiation treatment for cervical cancer, and the histology of the tumor was papillary serous adenocarcinoma, a malignant variant of endometrial cancer. Six patients underwent second look operation following the planned IAP treatment courses, and the operation confirmed no pathological evidence of disease in any, although in one disease recurred 7 months after the second laparotomy. Side effects were remarkable, including an 87% incidence of grade 4 leucopenia. However, the patients recovered spontaneously from the hematologic toxicity within 3 weeks of treatment. Other toxic effects including central nervous system toxicity were controllable and acceptable. The results indicated that IAP combination therapy was feasible and promising in the management of patients with endometrial carcinoma.
7例子宫内膜癌患者术后接受异环磷酰胺（1g/m²，每日1次，共5天）联合阿霉素（50mg/m²）和顺铂（50mg/m²）于第1天给药的化疗方案（IAP）。除1例无肌层浸润的患者外，所有患者均接受了5个疗程或更多疗程的IAP治疗。4例可测量病灶的患者中，3例达到完全缓解（CR），另1例患者获得部分缓解（PR），有效率达100%。在PR病例中，该患者曾接受过宫颈癌放疗，肿瘤组织学类型为乳头状浆液性腺癌，是子宫内膜癌的一种恶性亚型。6例患者在完成计划的IAP治疗疗程后接受了二次探查手术，手术证实均无疾病病理证据，尽管有1例在第二次剖腹手术后7个月疾病复发。副作用显著，4级白细胞减少症发生率达87%。然而，患者在治疗后3周内血液学毒性自行恢复。包括中枢神经系统毒性在内的其他毒性作用可控且可接受。结果表明，IAP联合治疗在子宫内膜癌患者的管理中是可行且有前景的。
