大剂量异环磷酰胺联合方案治疗青少年晚期软组织肉瘤

Continuous-infusion high dose ifosfamide as salvage treatment for pre-treated soft tissue sarcoma in teenage patients

研究大剂量异环磷酰胺（IFO）治疗多柔比星（ADM）和常规剂量IFO失败的青少年晚期软组织肉瘤的疗效及不良反应。对27例青少年晚期软组织肉瘤（术后化疗10例,进展期患者17例）采用IFO总量12g/m^2持续静脉滴注6d治疗,每3周为1个疗程。进展期17例患者CR5例,PR2例,总有效率41.18%,随访4～48个月,中位生存期（22±3.35）个月,中位缓解时间（7.00±1.75）个月。主要不良反应为骨髓抑制,Ⅲ、Ⅳ度中性粒细胞减少占48.57%。初步研究结果提示,大剂量IFO治疗青少年晚期软组织肉瘤有一定的疗效,对常规ADM及IFO治疗失败后可作为挽救治疗方法。

The objective of the study to study the clinical efficacy and toxicity of high dose infosfamide （HDI） in the treatment of soft tissue sarcoma teenage patients who failed in the treatment with prior adriamycin and infosfamide at standard doses. Seventeen patients with advanced soft tissue sarcoma and 10 patients after surgical resection were treated with HDI administered by continuous infusion at a dose of 12 g/m^2 per cycle over six days. An overall response rate of 41.18% was observed with five complete andtwo partial remission to the advanced patients . In the follow up at 4-48 month, the overall median survival time was 22±3.35 months and the median response duration was 7.00±1.75 months. The major toxicity was myelosuppression, 48.57 % of patients experieneed grade Ⅲ , Ⅳ neutropenia. In conclusion, HDI is an active salvage regimen in anthracycline ＋/-standard dose ifosfamide for soft tissue sarcoma to teenage patients.