异环磷酰胺联合依托泊苷在多线难治性乳腺癌中的疗效及安全分析

Efficacy and safety of the combination of Ifosfamide with Etoposide in heavily pretreated breast cancer

目的:回顾性评价异环磷酰胺(IFO)与依托泊苷(VP-16)联合方案在多线难治性乳腺癌中的疗效及安全性。方法:化疗方案为IFO 1.5 g/m2,1～5 d静滴3 h;美司钠(Mesna)400 mg,于IFO静滴时1～5 d为0、4、8 h;1～3 d静滴VP-16 100 mg/m2,每4周为1个疗程,化疗周期不超过6个疗程。结果:总共42例患者接受联合方案化疗,客观缓解率(ORR)为26.2%(11/42),临床获益率为57.1%(24/42),平均缓解持续时间为5.3个月,无进展时间(TTP)为4.3个月。在10例三阴乳腺癌的亚组中,ORR为40.0%(4/10),临床获益率为70.0%(7/10),平均缓解持续时间为5.8个月,TTP为5.0个月。常见的毒副反应是血液学毒性,其中以中性粒细胞减少最常见,没有治疗相关死亡。结论:在多线难治性乳腺癌中,尤其是三阴乳腺癌,异环磷酰胺与依托泊苷联合方案可能是一个有效的化疗方案,毒副反应是可管理的。

Objective：To evaluate the efficacy and safety affiliated of the combination of Ifosfamide with Etoposide in heavily pretreated breast cancer retrospectively.Methods：The treatment schedule consisted of ifosfamide 1.5 g/m2 i.v 3 h infusion on day 1-5;mesna 400 mg i.v at 0,4,8 h after ifosfamide on day 1-5;and etoposide 100 mg/m2 i.v and given on day 1-3.The treatment cycle was repeated every 4 weeks,and no more than 6 cysles were performed.Result：42 patients were treated,objective response rate（ORR） was 26.2%（11/42）,the clinical benefit was 57.1%（24/42）,the median duration of response was 5.3 months,and the median time to disease progression（TTP） was 4.3 months.In the subgroup of 10 patients with triple-negative breast cancer（TNBC）,ORR was 40.0%（4/10）,the clinical benefit was 70.0%（7/10）,the median duration of response was 5.8 months,and TTP was 5.0 months.The most common treatment-related adverse events were hematologic toxicity,especially neutropenia,and no treatment-related death occurred.Conclusion：In heavily pretreated breast cancer,especially TNBC,the combination of Ifosfamide with Etoposide may be a effective regimen,and its adverse events are manageable.