异环磷酰胺联合化疗治疗晚期妇科恶性肿瘤

目的 对异环磷酰胺（ＩＦＯ）联合化疗治疗晚期妇科恶性肿瘤进行临床疗效和毒性评价。方法 ３４例患者中，２５例采用顺铂（ＰＯＤ）联合化疗后未控或复发的卵巢上皮癌患者采用ＩＥＰ方案（ＩＦＯ、Ｖｐ１６、ＰＤＤ）。５例子宫肉瘤、２例宫颈鳞癌治疗后肝或骨转移、１例子宫内膜癌肺转移采用ＩＦＯ联合化疗。除肿瘤进展仅用１个疗程外，余至少用２个疗程。结果 全级有效率３５．３％，完全缓解（ＣＲ）占８．８％。２６例卵巢上

Ifosfamide combination chemotherapy for advanced gynecologic malignancies

OBJECTIVE: To evaluate the clinical efficacy and toxicity of ifosfamide (IFO) combination chemotherapy in patients with advanced gynecologic malignancies. METHODS: Thirty-four patients with gynecologic malignancies were included in this series. Of the 34 patients, 26 with epithelial cancer of the ovary were previously treated with cisplatin-containing combination chemotherapy but failed to respond or recurred after treatment. They were treated with IEP (IFO, VP16, PDD) regimen. The remaining 8 patients with uterine sarcoma (5 cases), squamous-cell carcinoma of the uterine cervix with metastases to the liver or bone (2 cases), and endometrial carcinoma with lung metastases (1 case) were treated with IFO combination chemotherapy. At least two courses of treatment were given unless tumor progression occurred after the first course. RESULTS: The overall response rate was 35.3% including 8.8% complete response. The response rate of 26 patients with ovarian cancer was 30.8%. Two patients with PDD-sensitive tumor all achieved complete response, which lasted for one year. The response rate of the remaining 24 PDD-resistant patients was 25% with a mean duration of 5.5 months. There was no complete response. Two patients with cervical carcinoma and two of five patients with uterine sarcoma responded to IFO combination chemotherapy. Relatively severe hematological toxicity was observed, including grade III and IV leucopoenia and thrombocytopenia. Two patients died from severe toxicity. CONCLUSION: IFO combination chemotherapy is effective in treating recurrent or progressive gynecologic malignancies, especially PDD-sensitive ones. Myelosuppression is relatively severe which may be due to prior long term and intensive chemotherapy.