Nichols C R
Department of Medicine, Indiana University, Indianapolis 46220, USA.
Semin Oncol. 1995 Jun;22(3 Suppl 7):13-7.
Ifosfamide has been found to have antineoplastic activity in a variety of solid tumors. In germ cell tumors, the substitution of ifosfamide for bleomycin in the standard combination bleomycin/etoposide/cisplatin (BEP) did not improve efficacy and caused significantly more toxicity than BEP. This regimen (VIP), however, has shown promise when used with high-dose carboplatin/etoposide as salvage therapy in patients with germ cell tumors not responding to first-line BEP. It is unclear whether the addition of ifosfamide to the carboplatin/etoposide regimen results in an improved therapeutic outcome in patients with multiple recurrent germ cell tumors. In such patients, as well as in those with poor-risk germ cell cancer, high-dose chemotherapy given with hematopoietic growth factors and bone marrow rescue may have a role. In small cell lung cancer, single-agent ifosfamide has produced response rates of 48% to 76%. Currently, the role of ifosfamide is being defined in untreated and recurrent small cell lung cancer.
已发现异环磷酰胺在多种实体瘤中具有抗肿瘤活性。在生殖细胞肿瘤中，在标准联合方案博来霉素/依托泊苷/顺铂（BEP）中用异环磷酰胺替代博来霉素并未提高疗效，且比BEP引起的毒性明显更大。然而，当该方案（VIP）与高剂量卡铂/依托泊苷联合用于一线BEP治疗无效的生殖细胞肿瘤患者的挽救治疗时，已显示出前景。尚不清楚在卡铂/依托泊苷方案中添加异环磷酰胺是否会改善多次复发的生殖细胞肿瘤患者的治疗结果。在这类患者以及预后不良的生殖细胞癌患者中，给予造血生长因子和骨髓救援的高剂量化疗可能会发挥作用。在小细胞肺癌中，单药异环磷酰胺的缓解率为48%至76%。目前，异环磷酰胺在未经治疗和复发性小细胞肺癌中的作用正在明确。
