Nichols C R
Division of Hematology/Oncology, Indiana University School of Medicine, Indianapolis, 46202, USA.
Semin Oncol. 1996 Jun;23(3 Suppl 6):65-73.
Ifosfamide is currently the third most active agent in the treatment of germ cell cancer, behind cisplatin and etoposide. Ifosfamide has single-agent activity comparable to etoposide in very poor-prognosis, cisplatin-refractory disease. In the salvage setting, ifosfamide-based combination chemotherapy can be expected to achieve disease-free status in approximately 50% of cisplatin-sensitive testicular cancer patients, although half of these patients will eventually relapse. As first-line therapy in previously untreated poor-risk patients, ifosfamide-based chemotherapy is therapeutically equivalent to standard therapy but associated with increased toxicity, especially myelosuppression. The role of high-dose ifosfamide in dose-intensive carboplatin/etoposide regimens for the treatment of recurrent disease is unknown and awaits clarification in future research. Current research with this drug continues primarily in the realm of refining ifosfamide-based salvage therapy.
异环磷酰胺目前是治疗生殖细胞癌中活性排第三的药物，仅次于顺铂和依托泊苷。在预后极差、对顺铂耐药的疾病中，异环磷酰胺的单药活性与依托泊苷相当。在挽救性治疗中，基于异环磷酰胺的联合化疗有望使约50%对顺铂敏感的睾丸癌患者达到无病状态，尽管这些患者中有一半最终会复发。作为既往未治疗的高危患者的一线治疗，基于异环磷酰胺的化疗在治疗效果上与标准治疗相当，但毒性增加，尤其是骨髓抑制。大剂量异环磷酰胺在剂量密集型卡铂/依托泊苷方案治疗复发性疾病中的作用尚不清楚，有待未来研究进一步阐明。目前对这种药物的研究主要仍集中在优化基于异环磷酰胺的挽救性治疗领域。
