异环磷酰胺联合化疗治疗晚期妇科恶性肿瘤  

Ifosfamide combination chemotherapy for advanced gynecologic malignancies

作　　者：李晓光[1] 刘丽影[1] 吴令英[1] 张蓉[1] 李洪君[1] 洪婉君[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤研究所肿瘤医院妇科,北京100021

出　　处：《中华肿瘤杂志》2000年第4期330-332,共3页Chinese Journal of Oncology

摘　　要：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 ,2 6例采用顺铂 (PDD)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。除肿瘤进展者仅用 1个疗程外 ,余至少用 2个疗程。结果　全组有效率 35 .3% ,完全缓解(CR)占 8.8%。 2 6例卵巢上皮癌患者有效率为 30 .8% ,其中 2例对PDD敏感者 ,均达CR ,各缓解 1年 ;2 4例对PDD耐药者 ,有效率为 2 5 0 % ,无一例CR ,平均缓解期 5个月。 2例宫颈鳞癌和 5例子宫肉瘤中有 2例有效。全组有较严重的血液学毒性 ,Ⅲ、Ⅳ度白细胞和血小板减少分别占 47.3%和31.1% ,有 2例血液学毒性相关死亡。结论　IFO联合化疗是治疗复发或未控、特别是对PDD敏感的卵巢上皮癌、宫颈鳞癌以及子宫肉瘤的有效方案。患者有较严重的血液学毒性 。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.

关 键 词：子宫肿瘤 药物疗法 卵巢肿瘤 异环磷酰胺 

分 类 号：R730.5[医药卫生—肿瘤]