Vansteenkiste J, Vandebroek J, Mariën S, Roex L, Bertrand P, Bockaert J, De Beukelaar T, Deman R, De Muynck P, Ulrichts H
Department of Pneumology, Catholic University, Leuven, Belgium.
Lung Cancer. 1995 Dec;13(3):295-303. doi: 10.1016/0169-5002(95)00502-1.
The efficacy and toxicity of a regimen adding ifosfamide to the more classical cisplatin-vindesine combination was studied in patients with advanced non-small cell lung cancer. Sixty-four good performance patients with inoperable stage III or stage IV were treated with VIP: vindesine 3 mg/m2 days 1 and 8, ifosfamide 1200 mg/m2 and platinum 30 mg/m2 days 1, 2 and 3, repeated every 4 weeks, up to a maximum of six cycles. Response rate, clinical data and radiological tests were rigourously reviewed by a panel. Overall response rate was 39% (95% confidence interval, 27%-51%) with three patients achieving a complete response; response rate in stage III was 48%. Median survival was 9 months. Toxicity consisted mainly of bone marrow toxicity and nausea/vomiting, but was manageable. There was no renal toxicity greater than grade 2, four severe infections, but no treatment-related deaths.
VIP as mentioned above is very active in good performance patients with advanced non-small cell lung cancer. Its activity, together with its manageable toxicity--without severe renal or pulmonary toxicity--makes it an attractive candidate for induction chemotherapy.
在晚期非小细胞肺癌患者中研究了在更经典的顺铂-长春地辛联合方案中加入异环磷酰胺的方案的疗效和毒性。64例体能状态良好的Ⅲ期或Ⅳ期不可手术患者接受VIP方案治疗：长春地辛3mg/m²，第1天和第8天给药；异环磷酰胺1200mg/m²；顺铂30mg/m²，第1、2和3天给药，每4周重复一次，最多进行6个周期。一组人员严格审查了缓解率、临床数据和影像学检查结果。总缓解率为39%（95%置信区间，27%-51%），3例患者达到完全缓解；Ⅲ期患者的缓解率为48%。中位生存期为9个月。毒性主要包括骨髓毒性和恶心/呕吐，但可控制。未出现大于2级的肾毒性，有4例严重感染，但无治疗相关死亡。
上述VIP方案在体能状态良好的晚期非小细胞肺癌患者中活性很高。其活性以及可控制的毒性——无严重肾毒性或肺毒性——使其成为诱导化疗的一个有吸引力的选择。
