异环磷酰胺联合化疗治疗恶性肿瘤临床观察

［目的］评价异环磷酰胺联合化疗治疗多种晚期恶性肿瘤的疗效及毒性。［方法］１９９５年１０月～１９９８年４月，５５例晚期非小细胞肺癌、恶性淋巴瘤和乳腺癌等肿瘤患者接受合异环磷酰胺为主的联合化疗，其中非小细胞肺癌２８例，恶性淋巴瘤８例，乳腺癌７例，其他肿瘤１２例。肺癌的化疗方案为ＭＩＣ和ＮＩＰ方案，恶性淋巴瘤为ＩＨＯＰ和ＭＩＶＥ方案，乳腺癌为ＩＡＦ和ＩＭＦ方案。［结果］５５例患者可评价疗效和毒性。总有效率５０．９％，ＣＲ８例，ＰＲ２０例。肺癌、恶性淋巴瘤和乳腺癌有效率分别为 ３９．３％，７５．０％和５７．１％。白细胞减少率为８９．１％，３～４级减少分别为３６．４％。血红蛋白减少和血小板减少分别为６９．１％和３８．２％，３级以上减少少见。非血液学毒性主要有恶心、呕吐４９．１％，脱发６５．５％，肝功能异常１６．４％。［结论］异环磷酸胺联合化疗作为一、二线治疗对多种晚期恶性肿瘤均有一定疗效。含异环磷酰胺的化疗方案及提高异环磷酰胺剂量强度治疗常见恶性肿瘤，值得临床深入研究。

Ifosfamide - based Combination Chemotherapy in the Treatment of Advanced Malignancies

Purpose] To evaluate the effect and safety of ifosfanide - based combination chemotherapy in the treatment of advanced malignancies.[Methods] From October 1995 to April 1998,fifty - five patients received ifosfamide -based combination chemotherapy.Of 55 patients,28 patients were non- small cell lung cancer(NSCLC),8 non - Hodgkin's lymphoma(NHL),7 breast cancer and 15 other tumors. [Results]Fifty - five patients were evaluated. The overall response rate was 50.9%,with eight cmplete repose(CR) and 20 partial response (PR),39.3% in NSCLS,75% in NHL,55.1% in breast cancer,and 58.3% in other tumors.Leukopenia was occurred in 89.l% of patients, grade 3~4 toxicity accounted for 36.4%. Thrombopenia and anemia accounted for 69.1% and 38.2% respectively.Toxcicity over grade 3 was uncommon.Main non - hematologic toxicities were nausea and vomiting(49.1% ),alopecia(65.5%) and liver toxicity(16.4%).[Conclusion]It is shown that ifosfamide - based combination chemotherapy is active and tolerable in the various tumors as first and second line treatment.It was warrant for further study of treating common tumors with ifosfamide - based combination and of dose intensity escalation of ifosfamide.