异环磷酰胺、顺铂、阿霉素联合治疗非小细胞肺癌的临床观察

IFOSFAMIDE, ADRIAMYCIN AND CISPLATIN COMBINED CHEMOTHERAPY IN PATIENTS WITH ADVANCED NON SMALL CELL LUNG CANCER

目的：观察ＩＡＰ（异环磷酰胺加阿霉素加顺铂）方案治疗肺癌的疗效和毒副反应。方法：异环磷酰胺１．５～２．０ｇ／ｍ２，静滴，第１～５天，阿霉素４０ｍｇ／ｍ２，静注，第１天；顺铂５０ｍｇ，静注，第３～５天，或１００ｍｇ／ｍ２，静滴，第３天，联合治疗中晚期非小细胞肺癌３５例。结果：完全缓解７例，部分缓解１３例，稳定７例，恶化８例，有效率（ＣＲ＋ＰＲ）为５７．１％。中位缓解期５个月，中位生存期９个月。毒性反应达Ⅲ、Ⅳ度者，白细胞减少为６５．７％，呕吐为２０．０％，脱发为３７．１％。有１例发生出血性膀胱炎，３１．４％病例发生感染，其中２例死亡。结论：ＩＡＰ方案是目前治疗非小细胞肺癌疗效最好的方案之一，可列为首选方案，但其对血液系毒性作用大。

Objective To observe the effect and toxicreaction of IAP regimen in the treatment of lung cancer. Methods: Thirty five patients with advanced non small cell lung cancer(NSCLC) were treated with IAP regimen: Ifosfamide (IF), Adriamycin(ADM), Cisplatin(DDP). IF was given 1.5￣2.2 g.(m 2) -1 .d -1 intravenously, infusion(IV) during days 1￣5. ADM 40 mg.g.(m 2) -1 , IV at day 1, DDP 50 mg d -1 IV during days 3￣5, or 100mg.(m 2) -1 , IV infusion at day 3. Results: 7 patients achieved CR, PR 13, SD 7, PD 8, Total effective rates were 57.1%, medium response time 5 months (1 to 18M), medium survial time 9M (2 to 18M). According to pathology, response rate of adenocarcinoma (61.1%) and squamous cell (60.0%) were higher than others, toxicities in grade 3 or worse were:neutropenia 65 7%, vomiting 22.9%, baldness 37.1%, one severe hemorrhagic cystitis, 34.1% of patients suffered infection, Two treatment related death were due to infection of lung. Conclusions: IAP regimen is one of the best choice for the chemotherapy in patients with NSCLC cancer, and its toxicity, mainly myelosuppression, is serious, too.