大剂量异环磷酰胺持续静滴联合阿霉素治疗进展期软组织肉瘤的临床观察

Clinical observation of continuous-infusion with high-dose ifosfamide plus adriamycin on advanced soft tissue sarcomas

目的:评价大剂量异环磷酰胺持续72h静滴联合阿霉素治疗进展期软组织肉瘤的临床疗效和毒副反应。方法:2008年3月～2008年10月收治进展期软组织肉瘤患者15例,应用大剂量异环磷酰胺联合阿霉素治疗,异环磷酰胺总量12g/m2,持续静滴72h;阿霉素60mg/m2第1天静滴。21天为1周期。完成2～6周期,中位周期数为4。结果:全组患者CR 1例(6.67%),PR 1例(6.67%),SD 12例(80.0%),PD 1例(6.67%),有效率13.3%(2/15),疾病控制率93.3%(14/15)。中位无疾病进展生存期6个月(3～10个月),中位总生存期7个月(3～10个月)。主要毒副反应为粒细胞减少、胃肠道反应和脱发,其他毒副反应少见。结论:大剂量异环磷酰胺持续72h静脉滴注联合阿霉素方案治疗进展期软组织肉瘤可行,能够有效控制疾病进展,毒副反应可以耐受,值得进一步深入研究。

Objective：To evaluate the efficacy and adverse reaction of continuous-infusion with high-dose ifosfamide plus adriamycin on advanced soft tissue sarcomas（STS）.Methods：Fifteen patients with advanced soft tissue sarcoma were given a 72h continuous-infusion of ifosfamide at a total dose of 12g/m2 and adriamycin at a dose of 60mg/m2 on first day.Twenty-one days were regarded as 1 cycle and 2-6 cycles were completed.The median cycle number was 4.Results：One case had complete remission（6.67%）,1 case achived partial remission （6. 67% ）, 12 cases maintained a stable disease （80. 0% ）, and 1 case had progressive disease （6. 67% ）. The overall response rate was 13.3% （2/15）, disease control rate was 93.3% （14/15）. The progression-free survival was 3-10 months and median PFS was 6 months. The overall survival（OS） was 3-10 months and median OS was 7 months. The main adverse reactions were leukopenia, nausea/vomiting and alopeeia. Other adverse reactions were seldom observed. Conclusion： The chemotherapy regimen of continuous-infusion with high-dose ifosfamide plus adriamycin on advanced soft tissue sarcomas can control disease progression effectively and the side effects can be tolerable. So the clinical study is worth to go on.