Rose P G, Piver M S, Malfetano J H, Baker T R, Hempling R E, Recio F O
Department of Obstetrics and Gynecology, University of Massachusetts Medical Center, Worcester.
Cancer. 1993 Apr 1;71(7):2245-9. doi: 10.1002/1097-0142(19930401)71:7<2245::aid-cncr2820710714>3.0.co;2-p.
Ifosfamide is an active agent in cisplatin-resistant cervical cancer. To determine the response rate of the combination of cisplatin and ifosfamide, a Phase II study was conducted of the administration of the combination after weekly cisplatin induction therapy.
Forty-seven patients with advanced or recurrent cervical carcinoma were treated with 1 mg/kg of cisplatin weekly for six courses, followed by 20 mg/m2 of cisplatin and 1.2 g/m2 of ifosfamide daily for 3 days every 28 days.
Objective responses were seen in 11 of 40 (27.5%) assessable patients (complete response, 20%; partial response, 7.5%). The duration of response ranged from 3 months to 26+ months (median, 9+ months). All of the patients who responded to the cisplatin-ifosfamide combination initially responded to weekly cisplatin induction therapy. None of the four patients who had previously received chemotherapy responded. Grade 3 or 4 hematologic toxic effects occurred in 17 of 43 patients (39%). Neurologic and urologic toxic effects were infrequent. The current response rates are not better than the prior experience of the authors with other cisplatin combinations.
These results do not confirm the favorable reports of other authors with cisplatin-ifosfamide regimens in cervical carcinoma. The results of ongoing Phase III studies comparing cisplatin-ifosfamide with cisplatin alone in cervical carcinoma are awaited.
异环磷酰胺是顺铂耐药宫颈癌的一种有效药物。为确定顺铂与异环磷酰胺联合应用的缓解率，在每周顺铂诱导治疗后进行了该联合用药的II期研究。
47例晚期或复发性宫颈癌患者接受每周1mg/kg顺铂治疗，共6个疗程，随后每28天给予20mg/m²顺铂和1.2g/m²异环磷酰胺，每日1次，连用3天。
40例可评估患者中有11例（27.5%）出现客观缓解（完全缓解20%；部分缓解7.5%）。缓解持续时间为3个月至26 +个月（中位时间9 +个月）。所有对顺铂-异环磷酰胺联合用药有反应的患者最初对每周顺铂诱导治疗均有反应。4例先前接受过化疗的患者均无反应。43例患者中有17例（39%）出现3级或4级血液学毒性反应。神经和泌尿系统毒性反应少见。目前的缓解率并不优于作者之前使用其他顺铂联合方案的经验。
这些结果并未证实其他作者关于顺铂-异环磷酰胺方案治疗宫颈癌的良好报道。正在进行的比较顺铂-异环磷酰胺与单纯顺铂治疗宫颈癌的III期研究结果有待期待。
