Walters R S, Holmes F A, Valero V, Esparza-Guerra L, Hortobagyi G N
Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
Am J Clin Oncol. 1998 Aug;21(4):413-5. doi: 10.1097/00000421-199808000-00020.
The aim of this paper is to evaluate the activity of ifosfamide in previously treated patients with metastatic breast cancer. From June 1991 through November 1992, 29 patients with metastatic breast cancer were treated with single-agent ifosfamide, 2 g/m2 intravenously daily for 5 days, with mesna support. All patients had previously received chemotherapy; all but one had previously received cyclophosphamide. The ifosfamide-mesna regimen was the first-line metastatic regimen in 15 patients, the second-line metastatic regimen in 13 patients, and the third-line metastatic regimen in one patient. Two partial remissions (7%) were observed; both occurred in the first-line metastatic group. The partial remissions were noted in patients who had completed adjuvant cyclophosphamide therapy 60 and 91 months earlier. Both responses were seen in lung metastases. The response durations were 5 and 8 months on continued therapy. The main adverse effects were granulocytopenia, fatigue, nausea, vomiting, and stomatitis. At the dose used in this study, ifosfamide and mesna given without growth-factor support resulted in significant myelosuppression and produced only two partial remissions (7%) in 29 patients. Further study of ifosfamide as an isolated agent in previously treated patients is not warranted.
本文旨在评估异环磷酰胺对既往接受过治疗的转移性乳腺癌患者的疗效。从1991年6月至1992年11月，29例转移性乳腺癌患者接受了单药异环磷酰胺治疗，剂量为2 g/m²，静脉滴注，每日1次，共5天，并给予美司钠支持。所有患者既往均接受过化疗；除1例患者外，其余患者既往均接受过环磷酰胺治疗。异环磷酰胺-美司钠方案在15例患者中作为一线转移性治疗方案，在13例患者中作为二线转移性治疗方案，在1例患者中作为三线转移性治疗方案。观察到2例部分缓解（7%）；均发生在一线转移性治疗组。部分缓解见于分别在60和91个月前完成辅助性环磷酰胺治疗的患者。两例均为肺转移灶出现缓解。持续治疗时缓解持续时间分别为5个月和8个月。主要不良反应为粒细胞减少、乏力、恶心、呕吐和口腔炎。在本研究使用的剂量下，未给予生长因子支持的异环磷酰胺和美司钠导致了显著的骨髓抑制，在29例患者中仅产生了2例部分缓解（7%）。因此，对于异环磷酰胺作为单一药物用于既往接受过治疗的患者的进一步研究并无必要。
