Filtenborg T A, Hansen H H, Aage Engelholm S, Rørth M
Department of Oncology, University Hospital/Rigshospitalet, Copenhagen, Denmark.
Ann Oncol. 1993 Jun;4(6):485-8. doi: 10.1093/oxfordjournals.annonc.a058559.
Discouraging response duration and long-time survivals have so far been the result of cisplatin-containing combination chemotherapy against advanced or recurrent squamous cell carcinoma of the uterine cervix. In order to increase the platinum-based effect upon this tumor without an increase in the specific toxicity of cisplatin, we combined it with carboplatin, added ifosfamide, which has been shown to possess a comparable degree of single-agent activity.
Thirty-six patients with advanced or recurrent squamous cell carcinoma of the uterine cervix not curable by radiation or surgery were treated with a combination of ifosfamide 1.5 gr/m2 i.v. days 1-3, carboplatin 200 mg/m2 i.v. day 1, and cisplatin 50 mg/m2. Thirty-one patients were evaluable for response and 34 patients for toxicity.
Twenty-three patients responded (64%), 11 (31%) of them completely, and 12 (33%) partially. Median response duration was 23 weeks (range 8-107 weeks), reaching 27 weeks and 21 weeks for patients with and without disease in previously irradiated areas, respectively. Median survival is 40 weeks (range 1-114 weeks). Toxicity consisted mainly of moderate to severe myelosuppression, resulting in 2 toxic deaths.
The response rate, also for earlier irradiated areas, compares favorably with other known cisplatin-containing regimens. The combination deserves investigation in a randomized setting.
迄今为止，含顺铂的联合化疗用于治疗晚期或复发性子宫颈鳞状细胞癌时，反应持续时间令人沮丧且长期生存率较低。为了在不增加顺铂特异性毒性的情况下增强铂类对该肿瘤的疗效，我们将顺铂与卡铂联合使用，并加入了已显示具有相当程度单药活性的异环磷酰胺。
36例无法通过放疗或手术治愈的晚期或复发性子宫颈鳞状细胞癌患者接受了如下联合治疗：异环磷酰胺1.5g/m²静脉滴注，第1 - 3天；卡铂200mg/m²静脉滴注，第1天；顺铂50mg/m²。31例患者可评估反应，34例患者可评估毒性。
23例患者有反应（64%），其中11例（31%）完全缓解，12例（33%）部分缓解。中位反应持续时间为23周（范围8 - 107周），先前接受过放疗区域有疾病和无疾病的患者分别达到27周和21周。中位生存期为40周（范围1 - 114周）。毒性主要包括中度至重度骨髓抑制，导致2例毒性死亡。
该方案的反应率，包括对先前接受过放疗区域的反应率，与其他已知的含顺铂方案相比具有优势。该联合方案值得在随机对照研究中进一步探究。
